Others- 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Others:
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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Helpful
  1. Respects the opinions of other employees.
  1. Treats others with respect and dignity.
  1. Constructively receives criticism and suggestions from others.
  1. Forms working relationships with employees from other departments.

Empowering Others

Agree Unsure Disagree N/A
  1. Encourages employees to solve problems on their own.
  1. Allows employees to make their own decisions.
  1. Gives employees the opportunity to make their own decisions at work.
  1. Provides support and resources needed to accomplish goals.
  1. Gives employees input into the decision making process.


Agree Unsure Disagree N/A
  1. Keep staff informed about what is happening in the company
  1. Is ready to offer help
  1. Makes you feel enthusiastic about your work
  1. Sets an example for others to follow
  1. Delegate tasks effectively

Project Management

Agree Unsure Disagree N/A
  1. Organizes work and sets priorities as needed.
  1. Works with customers and clients to assess their needs and define project parameters.
  1. Regularly reviews project performance and goals.
  1. Develops action items, workplans, timelines, and criteria for projects.
  1. Able to adjust project schedule as needed to accommodate unforeseen issues.


Agree Unsure Disagree N/A
  1. Completes work to a high technical standard
  1. Follows-up and takes action when goals are not met to ensure better results in the future.
  1. Makes a plan for getting things done and drives execution of the strategic plan, actively supporting or leading initiatives to closure.
  1. Schedules time for self and others to optimize high priority and long term actions. Monitors progress towards business goals.
  1. Sets challenging goals for the department.


Agree Unsure Disagree N/A
  1. Consistently provides me with timely feedback for improving my performance.
  1. Organizes and schedules events, activities, and resources.
  1. Effectively organizes resources and plans
  1. Able to organize work.
  1. Ability to establish realistic goals.

Client Focus

Agree Unsure Disagree N/A
  1. Maintains strong relationships with clients.
  1. Satisfies client needs.
  1. Looks for opportunities that have a positive impact on Clients.
  1. Obtains feedback to ensure client needs are being met.
  1. Forms strong client relationships


Agree Unsure Disagree N/A
  1. Creates a culture that fosters and values collaboration.
  1. Provides assistance and support to other team members when needed
  1. Act as an effective team player
  1. Recognizes and respects the contributions and needs of each individual.
  1. Fosters respect and understanding among team members


Agree Unsure Disagree N/A
  1. Is not afraid to take corrective action when necessary.
  1. Motivates & supports others to gain skills
  1. Gets the job done.
  1. Makes effective decisions, even when under pressure.
  1. Effectively makes decisions

  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.