Initiative - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Initiative:
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.

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

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


What does Initiative mean?
It means that ...
  • I am able to initiate work on projects independently without direct supervision.
  • I build strong interpersonal relationships upon first meeting.
  • I expand the offerings of the department by working evenings and weekends.
  • I seize upon chances to improve the department's prospects.
  • I update the documentation as soon as the situation changes.

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

Business Acumen

What does Business Acumen mean?
It means that ...
  • I recognize trends in underlying data.
  • You anticipate marketplace opportunities and supports speed to market.
  • I understand our competitors and their strengths and weaknesses.
  • You maintain currency with laws, regulations, policies, procedures, trends, and developments.
  • You can effectively interpret and analyze data.

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

Commitment To Result

What does Commitment To Result mean?
It means that ...
  • You maintain persistence and dedication to achieving results.
  • You encourage commitment in others to obtain results.
  • You coordinate all department activities into a cohesive team effort.
  • You are able to focus on a task even when working alone.
  • You are willing to do whatever it takes-not afraid to have to put in extra effort.

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


What does Analytical mean?
It means that ...
  • You ask the "right" questions to size up or evaluate situations.
  • You implement data validation techniques and methods.
  • You use appropriate techniques to solve problems.
  • You analyze issues and reduce them to their component parts.
  • You prioritize various actions to be taken when solving a problem.

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


What does Vision mean?
It means that ...
  • You persuade others to follow the Company's vision.
  • You develop action plans to align your work with the goals of the organization
  • You clearly articulate a vision for your work and inspires others to support it
  • You understand the vision of the Company and promote it ahead of any self-interests.
  • You create a positive vision of the future for the Company.

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

Areas for Development

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