Recognition- 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Assessments Measuring Recognition:
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 Recognition mean?
It means that ...
  • You recognize individuals for a specific outstanding achievement.
  • You let employees know when they have done well
  • You find opportunities to recognize others.
  • You say "thank you" to show appreciation for work of others.
  • You reinforce and reward employees for accomplishing necessary goals.

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

Managing Performance

What does Managing Performance mean?
It means that ...
  • You ensure employees understand the goals of the organization/department.
  • You recognize and value good performance.
  • You set long and short term goals.
  • You ensure employees understand their performance expectations.
  • You present performance feedback in a clear and concise manner.

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

Change Management

What does Change Management mean?
It means that ...
  • You adopt changes to set and example for others to follow.
  • You support the Company's efforts to implement changes.
  • You address organizational and departmental resistance to changes.
  • You assist others in understanding changes to the organization.
  • You are effective in implementing new organizational vision and values.

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

Conflict Management

What does Conflict Management mean?
It means that ...
  • You identify and takes steps to prevent potential confrontations.
  • You help employees to think through alternative ways to resolve conflict situations.
  • You assist team members by helping them see the other point of view.
  • You clearly express expectations to others.
  • You try to understand others' point of view before making judgments

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

Customer Focus

What does Customer Focus mean?
It means that ...
  • I create documents that meet the customer's specifications.
  • You received good feedback from customers.
  • You identify the most pressing needs of each customer.
  • You provide excellent service to customers.
  • You focus on providing excellent customer service.

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

Areas for Development

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