Quality - 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Questionnaires Measuring Quality:
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 Quality mean?
It means that ...
  • You hold employees accountable for your quality of work.
  • You encourage employees to produce the best quality products.
  • You encourage others to produce the highest quality work products.
  • You analyze what occurred and re-adjusts accordingly when goals are not met.
  • You encourage others to achieve high quality standards.

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


What does Initiative mean?
It means that ...
  • I gladly seek additional responsibilities.
  • I take action to implement new changes in the policies and procedures.
  • I take corrective action to rectify issues.
  • I look for opportunities to move projects forward.
  • I take the initiative to solve pressing issues.

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


What does Leadership mean?
It means that ...
  • You demonstrate leadership and courage in critical situations.
  • You motivate and challenges employees to attain a shared vision.
  • You express clear goals and objectives.
  • You guide decision-making by coaching, counseling and rewarding.
  • 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.

Empowering Others

What does Empowering Others mean?
It means that ...
  • You give employees autonomy to complete tasks on their own.
  • You trust employees to complete tasks assigned.
  • You express confidence in the abilities of others.
  • You allow employees to have flexible work schedules.
  • You are aware of the skill levels of others.

To what extent does this person exhibit Empowering Others?
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 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.
  • You are effective in using company's resources.

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.