Results Oriented - 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Results Oriented Questionnaires:
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.

Results Oriented

  • Helps others when free-time is available.
  • Does not become distracted by non-issues or interruptions.
  • Inspires and motivates co-workers to be productive and energetic at work
  • Directs team in prioritizing daily work activities
  • Works toward achievement of goals even when confronted with obstacles.
If [Participant Name] were to make improvements in Results Oriented, what are your suggestions for how he/she can improve this?


  • Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
  • Works effectively in dynamic and changing work environments.
  • Develops insights and applies innovative solutions to projects and problems.
  • Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  • Is proactive and takes steps to prepare for changes in the workplace.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?


  • Seeks feedback to enhance performance.
  • Considers other's opinion and suggestions.
  • Is visible and approachable.
  • Is easy to approach with ideas and opinions.
  • Shares past experiences with others as learning opportunities.
If [Participant Name] were to make improvements in Feedback, what are your suggestions for how he/she can improve this?


  • Conducts appointments at scheduled start time.
  • Starts meetings on time.
  • Starts the workday when scheduled.
  • Responds to requests for information in a timely manner.
  • Arrives to meetings on time.
If [Participant Name] were to make improvements in Punctuality, what are your suggestions for how he/she can improve this?

Project Management

  • Regularly reviews project performance and goals.
  • Works with customers and clients to assess their needs and define project parameters.
  • Develops action items, workplans, timelines, and criteria for projects.
  • Inspires others to accomplish goals and objectives.
  • Maintains costs and expenses within budget limits.
If [Participant Name] were to make improvements in Project Management, 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.