Others- 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Assessments 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)

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. Supports the efforts of other employees in implementing solutions to problems.
  1. Works across boundaries within the organization.
  1. Consistently demonstrates ability and willingness to trust others.
  1. ...treats others with respect and dignity.
  1. Treats others with respect and dignity.

Administrative Skill

Definite Strength Meets Standards Needs Development N/A
  1. Enthusiastic about taking on challenging projects.
  1. Completes reports on-time.
  1. Takes responsibility for decisions.
  1. Able to develop, justify and present a budget.
  1. Accurately implements contract provisions.


Definite Strength Meets Standards Needs Development N/A
  1. Able to influence others.
  1. Is a highly effective supervisor.
  1. Sets specific, measurable, and challenging goals.
  1. Recognizes individual and team accomplishments and reward them appropriately.
  1. Guides decision-making by coaching, counseling and rewarding.

Supervisory Skills

Definite Strength Meets Standards Needs Development N/A
  1. Values the opinions of subordinates.
  1. Listens to others.
  1. Delegates effectively.
  1. Seeks to enhance the performance of employees under their supervision.
  1. Maintains an even temper in stressful situations.


Definite Strength Meets Standards Needs Development N/A
  1. Inspires creativity in their team.
  1. Is creative.
  1. Adds value to the department/organization.
  1. Conceives, implements and evaluates ideas.
  1. Is creative and inspirational.

Passion To Learn

Definite Strength Meets Standards Needs Development N/A
  1. Creates an environment that supports personal development and exploration.
  1. Is open minded and curious about learning new skills.
  1. Will participate in training classes even if offered outside of normal working hours.
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
  1. Enjoys learning new skills and techniques.

Juggling Multiple Responsibilities

Definite Strength Meets Standards Needs Development N/A
  1. Ensures that assignments are prioritized according to the needs of the department/company.
  1. Observes, analyzes, and responds to merchandise needs while serving customers and accomplishing operational tasks.
  1. Determines which tasks are critical and which tasks are optional.
  1. Assigns tasks based on skills of team members.
  1. Uses a scheduler/planner to keep tasks organized and on time.


Definite Strength Meets Standards Needs Development N/A
  1. Clearly defines work objectives for employees.
  1. Makes sure employees understand why they were given certain assignments.
  1. Is clear about the roles and duties of team members.
  1. Uses appropriate grammar and tense in communications.
  1. Is clear about goals that need to be achieved.


Definite Strength Meets Standards Needs Development N/A
  1. Communicates an understanding of the other person's interests, needs and concerns.
  1. Takes care to maintain confidential information.
  1. Demonstrates congruence between statements and actions.
  1. Works in a way that makes others want to work with her/him.
  1. Demonstrates a sense of responsibility and commitment to public trust.


Definite Strength Meets Standards Needs Development N/A
  1. Creates the conditions for partnerships to grow and develop.
  1. Supports a partnering/networking culture.
  1. Forges mutually beneficial relationships between individuals with diverse backgrounds.
  1. Maintains infrastructure to support partnerships and networks.
  1. Partners with peers to obtain influence within the Company.

  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.