Innovation - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Questionnaires Measuring Innovation:
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.

Sample Result Document:
Sample Results
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. Offers constructive improvements to existing systems.
  1. Searches for opportunities and innovative ways to improve the organization.
  1. Creates improved methods or solutions for meeting goals and objectives.
  1. Finds creative ways to get things done with limited resources.
  1. Creates a safe environment for idea-sharing.

Communication Skills

Definite Strength Meets Standards Needs Development N/A
  1. Able to deliver presentations.
  1. Delivers influential presentations.
  1. Presents issues, ideas, and strategy concisely and clearly.
  1. Communicates effectively with colleagues and customers
  1. Delivers information in a clear, concise, and logical manner.


Definite Strength Meets Standards Needs Development N/A
  1. Adapts to circumstances as needed.
  1. Willing to try new ideas.
  1. Is open to alternative ways to accomplish goals
  1. Encourages others to adopt new procedures.
  1. Implements changes as a result of having listened to employees

Bias for Action

Definite Strength Meets Standards Needs Development N/A
  1. Seeks and utilizes opportunities for continuous learning and self-development.
  1. Coach others to foster an environment which can adapt quickly and willingly to rapid change.
  1. Displays high energy and enthusiasm on consistent basis.
  1. Projects a "can-do" attitude when interfacing with peers, subordinates and customers(especially during difficult and challenging times).
  1. Encourages risk taking and experimentation to improve performance

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Ensures that team goals are met 85 percent of the time.
  1. Makes sure commitments are understood and met.
  1. Provides employees with training as needed to increase their performance.
  1. Reviews job performance shortly after completion of tasks.
  1. Continuously measures performance and provides feedback to employees regularly.

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. High attention to detail.
  1. Implements and uses performance measures.
  1. Strong organizational skills to keep the workspace and department in order
  1. Has strong technical/computer skills.
  1. Completes reports on-time.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Avoids distractions in the workplace.
  1. Does not become flustered by deadlines and timelines.
  1. Prioritizes new tasks according to their relative importance.
  1. Deals effectively with interruptions.
  1. Uses agendas when chairing or facilitating meetings.


Definite Strength Meets Standards Needs Development N/A
  1. Behavior is ethical and honest.
  1. Responsible for setting the vision of the department.
  1. Completes assigned work tasks.
  1. Sets high personal standards of performance.
  1. Works in a way that makes others want to work with her/him.


Definite Strength Meets Standards Needs Development N/A
  1. Understands the expectations of other parties in the negotiation.
  1. Researches the needs of the other party to identify strengths and weaknesses of positions.
  1. Is able to decline bad ideas to avoid making poor decisions.
  1. Able to control their emotional responses and correctly gauge the emotions of others.
  1. Resolves difficult negotiations whether it is a contract, sub contract, legal or any other difficult negotiation fairly and reasonably.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Understands departmental policies and procedures.
  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. Effective in communicating with others within the organization.
  1. Able to deal with sensitive issues with tact and professionalism.

  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.