Feedback - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Questionnaires Measuring Feedback:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing development.

Partially completed forms can be saved by using the Save/Still Working button at the bottom of the page. You may return at a later time to complete/edit the form. Your saved responses will be shown each time you re-visit the feedback form. When you are certain that you have completed your responses and will be not making any changes, click the Complete button.


Definite Strength Meets Standards Needs Development N/A
  1. Asks others for their ideas and opinions.
  1. Seeks feedback to enhance performance.
  1. Is visible and approachable.
  1. Looks to others for input.
  1. Is easy to approach with ideas and opinions.

Emotional Intelligence

Definite Strength Meets Standards Needs Development N/A
  1. Is able to manage their own emotions.
  1. Accurately perceives the emotional reactions of others.
  1. Is able to express themselves clearly.
  1. Able to understand others' points of view.
  1. Is attentive to emotional cues and interprets others' feelings correctly.

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Measures performance against goals and objectives.
  1. Obtains commitment from employees regarding completion of tasks.
  1. Sets and maintains high standards for self and others.
  1. Is consistent in disciplinary/corrective actions.
  1. Recognizes and values good performance.


Definite Strength Meets Standards Needs Development N/A
  1. Can handle changes without complaining.
  1. Identifies new opportunities to achieve goals
  1. Works effectively during periods of change.
  1. Acts decisively in frequently changing and uncertain environment.
  1. Willing to try new ideas.

Bias for Action

Definite Strength Meets Standards Needs Development N/A
  1. Displays high energy and enthusiasm on consistent basis.
  1. Encourages risk taking and experimentation to improve performance
  1. Completes a large volume of work.
  1. Motivates others to achieve or exceed goals
  1. Seeks and utilizes opportunities for continuous learning and self-development.


Definite Strength Meets Standards Needs Development N/A
  1. Uses appropriate techniques to solve problems.
  1. Implements data validation techniques and methods.
  1. Identifies opportunities for progress and innovation.
  1. Analyzes issues and reduces them to their component parts.
  1. Selects the appropriate techniques for analysis.


Definite Strength Meets Standards Needs Development N/A
  1. Makes sure that I have a clear idea of our group's goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Understands & contributes to development of strategic goals.
  1. Establishes and documents goals and objectives.
  1. Goal Setting

Technology Use/Management

Definite Strength Meets Standards Needs Development N/A
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Supports technical training and development of employees.
  1. Applies complex rules and regulations to maintain optimal system performance.
  1. Proficient in the use of technical systems and processes.
  1. Maximizes the use of new technology to deliver products and services.

Empowering Others

Definite Strength Meets Standards Needs Development N/A
  1. Encourages employees to solve problems on their own.
  1. Provides support and resources needed to accomplish goals.
  1. Allows individuals to be responsible for their decisions.
  1. Encourages others to obtain necessary skills and training.
  1. Avoids micromanaging their employees.


Definite Strength Meets Standards Needs Development N/A
  1. Comes across as a reliable, committed team member
  1. Creates a climate that encourages team participation.
  1. Encourages others to share ideas to develop team cohesion
  1. Coaches team members
  1. Actively participates in the work of teams; seeks and listens to others' contributions

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Understands departmental policies and procedures.
  1. Able to use corporate politics to advance department objectives.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Able to explain departmental policies and procedures to others.
  1. Anticipates problems that may affect the department.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.