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Performance - 360 Degree Feedback Survey Sample #1





360-Degree Feedback Survey

Questionnaires Measuring Performance:
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)
Survey 13 (4-point scale; numbers; floating anchors)
Survey 14 (4-point scale; N/A)
Instructions:

[Company] is conducting a 360-Degree Feedback Assessment developed by HR-Survey for selected managers.

You have been selected to provide feedback on the employee listed above. Your feedback is an important part of our company's leadership development process and this survey 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 questions below, think about your experiences working with this employee over the last twelve months. The effectiveness of this development tool is dependent on your honest, forthright and constructive responses so please bear this in mind as you answer each question. Your responses will be aggregated with the responses received from others and discussed with the employee to foster growth and on-going 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.

Competencies Included:
Performance, Achievement, Empowering Others, Teamwork, Adaptability, Action, Continual Learning, Leadership, Company, Vision
Sample Result Document:
Sample Results
Your feedback is valuable in helping the individual to understand how they are perceived and experienced by others and the impact their behavior has on people in the organization with whom they interact. Feedback received also acknowledges strengths and identifies areas for development.

Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final feedback.

Please ensure that your submission is made between . The survey will only be available during these dates.

Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for 100% participation.

Management Team
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Performance

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Responds to mistakes with composure and a focus on solutions rather than blame.
  1. Responds to unexpected challenges with agility rather than hesitation.
  1. Works well in this position.
  1. Takes action to create conditions where the team can operate at peak effectiveness?
  1. Owns both the outcome and the process that led to the mistake.
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Achievement

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Demonstrates a well-organized and timely approach to achieve desired results
  1. Implements standardized processes and procedures to help others achieve success.
  1. Always works to improve the processes and procedures.
  1. Is flexible in adjusting priorities to meet the demands of changing situations.
  1. Leverages key performance indicators (KPIs) to track results and adjust strategies for optimal outcomes.
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?

Empowering Others

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Coordinates the knowledge, skills and resources of others to accomplish more in the department.
  1. Identifies and sponsors employees for high-visibility assignments or leadership opportunities.
  1. Sets goals to allow the employee to have more autonomy over their work.
  1. Demonstrates confidence in the abilities of subordinates.
  1. Helps employees prioritize goals when workload or competing demands create ambiguity.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?

Teamwork

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Able to work closely other team members who are considered to be difficult to work with.
  1. Coaches team on how to solve problems, plan, and meet organizational goals and objectives.
  1. Willing to do what it takes to help the team reach its goals.
  1. Makes eye contact when listening to colleagues.
  1. Committed to the successful completion of team goals.
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

Adaptability

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Uses a variety of tools and equipment to service the machines/products.
  1. Learns new skills to become competitive and contribute to the bottom line.
  1. Works with managers who may focus on different areas.
  1. Develops new and innovative ideas and approaches for solving problems.
  1. Able to work within uncertain environments.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?

Action

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Takes on additional responsibilities outside of the job description to help the team succeed.
  1. Rapidly adapts to changes in the situation.
  1. Takes proactive steps to address potential issues before they became a problem.
  1. Establishes the tasks and direction for the team.
  1. Works quickly to get the job done.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?

Continual Learning

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Sets relevant learning objectives and goals.
  1. Takes charge of their training and skills enhancement.
  1. Builds on their strengths while addressing their weaknesses.
  1. Seeks opportunities to grow in skills and knowledge.
  1. Views setbacks as opportunities to learn from.
If [Participant Name] were to make improvements in Continual Learning, what are your suggestions for how he/she can improve this?

Leadership

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Gains cooperation, support, and buy-in of others.
  1. Implements Philosophy/Mission-based initiatives within work environment and monitors results
  1. Maximizes the efforts of all team members.
  1. Encourages calculated risk-taking and treats mistakes as learning opportunities, not failures.
  1. Influences the organization.
If [Participant Name] were to make improvements in Leadership, what are your suggestions for how he/she can improve this?

Company

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Communicates the importance of company initiatives with clarity and enthusiasm.
  1. Paints a compelling picture of the company's future and inspires others to work toward it.
  1. Serves as a trusted ambassador of the company's values, delivering strategic outcomes that reinforce client confidence.
  1. Ensures transparency in performance evaluations, promotions, and compensation decisions.
  1. Leads efforts to ensure offerings are not only competitive but also meaningful and differentiated.
If [Participant Name] were to make improvements in Company, what are your suggestions for how he/she can improve this?

Vision

Needs
Improvement
Meets
Minimum
Standards
Is
Proficient
Role
Model
  1. Develops a vision that strengthens organizational identity, reinforcing who the company is and what it stands for.
  1. Clearly articulates a vision for his/her work and inspires others to support it
  1. Is able to diagnose issues and problems and to create a vision for their solutions.
  1. Establishes a timeline for attainment of the organization's vision.
  1. Shapes strategies that resonate with the department's shared vision.
If [Participant Name] were to make improvements in Vision, what are your suggestions for how he/she can improve this?

  1. What are [Participant Name Here]'s greatest strengths demonstrated this year?


  2. What are [Participant Name Here]'s areas for development?


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