Leadership - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Leadership:
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 Leadership mean?
It means that ...
  • You demonstrate leadership and courage in critical situations.
  • You are able to organize the work of others.
  • You are a highly effective supervisor.
  • You give inspiring presentations or discussions.
  • You set a high level of performance expectations and challenges others to do the same.

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

Decision Making

What does Decision Making mean?
It means that ...
  • You make decisions based on novel interpretations of the facts.
  • I am receptive to new ideas from others when making decisions.
  • You break complex issues into manageable parts and organize them in a systematic way before making decisions
  • You make decisions independently (without having to be told what or how).
  • You apply creative reasoning in making decisions.

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


What does Achievement mean?
It means that ...
  • You complete work to a high technical standard
  • You accept setbacks and challenges as improvement opportunities
  • You are driven to complete assignments on time.
  • You demonstrate improvement in performance.
  • You are determined to complete tasks regardless of obstacles that may occur.

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

Co-worker Development

What does Co-worker Development mean?
It means that ...
  • You work to identify root causes of performance problems
  • You take immediate action on poor performance
  • You set and clearly communicate expectations, performance goals, and measurements to others
  • You provide ongoing feedback to co-workers on your development progress
  • You adapt coaching and mentoring approach to meet the style or needs of individuals

To what extent does this person exhibit Co-worker Development?
Select from one of the ratings below.

Fiscal Management

What does Fiscal Management mean?
It means that ...
  • You keep excellent records for financial transparency.
  • You effectively manage appropriations, reporting, purchases, expenditures, payrolls, and staff.
  • You provide budgeting and accounting support to the Company.
  • You develop budgets and plans for various programs and initiatives.
  • You ensure others follow the correct rules and regulations on fiscal matters.

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

Areas for Development

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