Innovation - 360 Degree Feedback Survey Sample #11

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.

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 Innovation mean?
It means that ...
  • You solve problems with insight and understanding.
  • You find creative ways to get things done with limited resources.
  • You suggest new ideas at meetings.
  • You implement best practices within the department.
  • You search for opportunities and innovative ways to improve the organization.

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

Change Management

What does Change Management mean?
It means that ...
  • I facilitate change with minimal resistance.
  • I develop strategies for implementing changes.
  • I inspire others to accept the recent changes.
  • You are effective in implementing new organizational vision and values.
  • You are effective in dealing with ambiguous and challenging situations.

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

Self Management

What does Self Management mean?
It means that ...
  • You do not allow own emotions to interfere with the performance of others.
  • You use patience and self-control in working with customers and associates.
  • You analyze own reactions on the spot to ensure that communication does not appear to be driven by anger.
  • You step away from a situation to process appropriate response.
  • You consciously control own negative emotions in order to keep team morale up.

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


What does Punctuality mean?
It means that ...
  • You start meetings on time.
  • You start the workday when scheduled.
  • You invoice clients on a timely basis.
  • You respond to requests for information in a timely manner.
  • You avoid making personal phone calls during working hours.

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

Time Management

What does Time Management mean?
It means that ...
  • You avoid distractions in the workplace.
  • You complete high-priority work within required timelines.
  • You do not become flustered by deadlines and timelines.
  • You use agendas when chairing or facilitating meetings.
  • You keep and maintain a To-Do list.

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

Areas for Development

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