Feedback - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

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Feedback

What does Feedback mean?
It means that ...

• You consistently review work achievements in relation to defined goals and criteria and recognize areas for potential improvement.
• I leverage feedback responsibly to enhance professional skills and ensure it is applied in a respectful and appropriate manner.
• You use structured formats (e.g., SBI: Situation-Behavior-Impact) to enhance clarity and specificity.
• I actively seek and value feedback from a variety of sources, include peers, supervisors, and external stakeholders.
• You are visible and approachable.

To what extent does this person exhibit Feedback?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Project Management

What does Project Management mean?
It means that ...

• I plan who, when, and what work needs to get done.
• You investigate potential risks of different courses of action.
• You define project outcomes based on customer requirements.
• I determine the appropriate strategy for mitigating specific risks.
• I identify the potential risks for each phase of the project.

To what extent does this person exhibit Project Management?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Decision Making

What does Decision Making mean?
It means that ...

• I am able to make decisions quickly.
• You conduct post-decision reviews to learn from outcomes and improve future evaluations.
• I make creative decisions.
• You have a good rapport other people which is helpful in making decisions on the team.
• I make clear what is in scope and out of scope to avoid misalignment or unrealistic expectations.

To what extent does this person exhibit Decision Making?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Safety

What does Safety mean?
It means that ...

• You perform work safely.
• You identify and addresses safety needs.
• You identify predictable hazards in the workplace.
• You are aware of osha safety guidelines.
• You develop safety guidelines for the department.

To what extent does this person exhibit Safety?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Co-worker Development

What does Co-worker Development mean?
It means that ...

• You set and clearly communicate expectations, performance goals, and measurements to others
• You give others development opportunities through project assignments and increased job responsibilities
• You take immediate action on poor performance
• You adapt coaching and mentoring approach to meet the style or needs of individuals
• You provide ongoing feedback to co-workers on your development progress

To what extent does this person exhibit Co-worker Development?
Select from one of the ratings below.

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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