Results Oriented - 360 Degree Feedback Survey Sample #11

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.

Results Oriented

What does Results Oriented mean?
It means that ...
  • You demonstrate the personal confidence to "stay the course," even when faced with difficulty
  • You encourage a high-energy, fun work environment and coaches others on how to do the same
  • You provide clear expectations for employees.
  • You inspire and motivates co-workers to be productive and energetic at work
  • You stay focused on meeting the needs of customers.

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

Decision Making

What does Decision Making mean?
It means that ...
  • You assess the risks, benefits, and potential impact of a number of options when deciding a course of action
  • You exercise good judgment by making sound and informed decisions.
  • You are able to make decisions quickly.
  • You do not lose sight of the big picture when making decisions
  • You ask for additional information when making critical decisions.

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


What does Action mean?
It means that ...
  • You make effective decisions
  • You drive and mobilizes others progress toward goals.
  • You work quickly when faced with difficult problems.
  • You get the job done.
  • You do whatever it takes (within reason) to get the job done.

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


What does Management mean?
It means that ...
  • You make others feel enthusiastic about your work
  • You are ready to offer help
  • You set an example for others to follow
  • You keep staff informed about what is happening in the company
  • You take responsibility for things that go wrong

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


What does Attitude mean?
It means that ...
  • You contribute to a positive and fun work environment.
  • You contribute to a positive work environment.
  • You treat all people fairly and with respect.
  • You work to eliminate unnecessary work or barriers that get in others' way.
  • You visibly support and encourages diversity in style and background.

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

Areas for Development

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