Planning- 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Assessments Measuring Planning:
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.


  • Able to look ahead (beyond the present) when addressing the work/needs of the department.
  • Anticipates obstacles and ways to overcome them.
  • Works in an organized manner
  • Able to identify the needs of the department before a major change.
  • Anticipates potential challenges, develops plan to overcome them and then carries out the plan.
If [Participant Name] were to make improvements in Planning, what are your suggestions for how he/she can improve this?

Managing Performance

  • Prioritizes the work of others.
  • Provides employees with necessary resources to accomplish their goals.
  • Makes sure commitments are understood and met.
  • Uses timely and appropriate corrective/disciplinary actions.
  • Reviews job performance shortly after completion of tasks.
If [Participant Name] were to make improvements in Managing Performance, what are your suggestions for how he/she can improve this?

Commitment To Result

  • Maintains persistence and dedication to achieving results.
  • Able to focus on a task even when working alone.
  • Takes immediate action toward goals.
  • Creates a sense of urgency among the store team members to complete activities, which drive sales.
  • Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
If [Participant Name] were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?

Empowering Others

  • Sets clear goals for others to accomplish.
  • Encourages employees to solve problems on their own.
  • Avoids micromanaging their employees.
  • Encourages others to obtain necessary skills and training.
  • Provides support and resources needed to accomplish goals.
If [Participant Name] were to make improvements in Empowering Others, what are your suggestions for how he/she can improve this?


  • Expresses loyalty and dedication to [Company] in interactions with others.
  • Understands the use of [Company] products and services.
  • Follows existing procedures and processes.
  • Impresses upon others the important aspects of [Company].
  • Attends [Company] gatherings and social events.
If [Participant Name] were to make improvements in Company, 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.