Integrity - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Questionnaires Measuring Integrity:
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.


  • Develops trust and confidence from others.
  • Fosters an environment built upon trust.
  • Demonstrates honesty and truthfulness at all times.
  • Fosters a high standard of ethics and integrity.
  • Follows tasks to completion.
If [Participant Name] were to make improvements in Integrity, what are your suggestions for how he/she can improve this?


  • Works effectively with various personalities of team members.
  • Adjusts to new plans and procedures.
  • Able to step in and help co-workers when needed.
  • Recognizes and implements changes to enhance efficiency and effectiveness.
  • Able to adapt to changes in technology and processes.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?


  • Eliminates bureaucratic barriers to streamline processes.
  • Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  • Sets ambitious standards of performance.
  • Driven to complete assignments on time.
  • Accepts setbacks and challenges as improvement opportunities
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Customer Focus

  • Uses feedback from the customer to help improve the customer's experience.
  • Keeps the customer informed of all progress.
  • Has received good feedback from customers.
  • Maintains up-to-date information regarding customer products.
  • Anticipates potential obstacles to meeting customer needs.
If [Participant Name] were to make improvements in Customer Focus, what are your suggestions for how he/she can improve this?


  • Maintains infrastructure to support partnerships and networks.
  • Collaborates with others to accomplish goals and objectives.
  • Supports and encourages relationships that are created by diverse team members.
  • Supports a partnering/networking culture.
  • Partners with peers to obtain influence within the Company.
If [Participant Name] were to make improvements in Partnering/Networking, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

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