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 ...
  • You take the initiative to change the direction or course of events.
  • You seek and utilize opportunities for continuous learning and self-development.
  • You go above and beyond the stated goals.
  • You take decisive action to address problems, following up with relevant team members and coaching them on how to improve.
  • You take action without being asked.

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 ...
  • You are able to align resources to meet the business needs of the company.
  • You understand complex issues and problems.
  • You apply the knowledge of work processes to influence the achievement of business goals
  • You ask the 'right' questions to size up or evaluate situations.
  • You exhibit behavior that is consistent with the vision, mission, and core values of the organization

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 coordinate all department activities into a cohesive team effort.
  • You convey strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  • You are willing to do whatever it takes-not afraid to have to put in extra effort.
  • You maintain persistence and dedication to achieving results.
  • You take immediate action toward goals.

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 identifiy opportunities for progress and innovation.
  • You identify problems and issues needing resolution.
  • You identify the root cause of a problem.
  • You implement data validation techniques and methods.
  • You analyze data and information from several sources and arrives at logical conclusions.

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


What does Vision mean?
It means that ...
  • You communicate the vision and strategy of [Company]
  • You communicate a vision of where the Company needs to be in the future.
  • You expresse the Company vision in a way that is easily understood and adopted by employees.
  • You demonstrate consistency between words and actions
  • 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.