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. Challenges current procedures to develop other alternatives.
  1. Searches for opportunities and innovative ways to improve the organization.
  1. Suggests new ideas at meetings.
  1. Creates improved methods or solutions for meeting goals and objectives.
  1. Analyzes current procedures and identifies opportunities for improvement.

Communication Skills

Definite Strength Meets Standards Needs Development N/A
  1. Able to demonstrate persuasiveness in pursuit of objectives.
  1. Delivers information in a clear, concise, and logical manner.
  1. Asks follow-up questions as needed.
  1. Presents issues, ideas, and strategy concisely and clearly.
  1. Communicates effectively with colleagues and customers


Definite Strength Meets Standards Needs Development N/A
  1. Encourages others to adopt new procedures.
  1. Adapts to new organizational structures, policies, or procedures.
  1. Works effectively during periods of change.
  1. Is open to alternative ways to accomplish goals
  1. Willing to try new ideas.

Bias for Action

Definite Strength Meets Standards Needs Development N/A
  1. Encourages risk taking and experimentation to improve performance
  1. Conveys a sense of urgency about addressing problems and opportunities
  1. Identifies ways to simplify work processes and reduce cycle times
  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).

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Routinely holds audits of performance on a weekly or monthly basis.
  1. Provides employees with training as needed to increase their performance.
  1. Presents performance feedback in a clear and concise manner.
  1. Adjusts performance goals as needed to meet the demands of the department/organization.
  1. Measures performance of goals and objectives.

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. Enthusiastic about taking on challenging projects.
  1. High attention to detail.
  1. Has strong technical/computer skills.
  1. Strong organizational skills to keep the workspace and department in order
  1. Takes responsibility for decisions.

Time Management

Definite Strength Meets Standards Needs Development N/A
  1. Prioritizes new tasks according to their relative importance.
  1. Sets clearly defined goals.
  1. Leaves time in the schedule for unplanned contingencies.
  1. Completes tasks ahead of schedule.
  1. Sets a good balance between work and family life.


Definite Strength Meets Standards Needs Development N/A
  1. Behavior is ethical and honest.
  1. Acts as a resource without removing individual responsibility.
  1. ...takes personal responsibility for results.
  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. Able to influence others to accept certain positions.
  1. Stays calm and focuses on the core issues to be discussed.
  1. Actively listens to conversations to be able to recall important details later.
  1. Is able to decline bad ideas to avoid making poor decisions.
  1. Identifies verbal and nonverbal cues to help interpret actions and messages.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Anticipates problems that may affect the department.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.
  1. Gets things done through the department.
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Understands the current organizational culture.

  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.