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 provide clear expectations for employees.
  • You direct team in prioritizing daily work activities
  • You encourage a high-energy, fun work environment and coaches others on how to do the same
  • You work toward achievement of goals even when confronted with obstacles.
  • You explain the "whys" behind organizational objectives

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 ...
  • I have enough self-control to avoid making impulsive decisions.
  • I make good decisions for the Department.
  • You decide which long-term goals should be met.
  • You use reasonable assumptions and logic to decide between alternate courses of action
  • You coach team members individually when "poor" decisions are made and helps them see what could have been done differently

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


What does Action mean?
It means that ...
  • You motivate & supports others to gain skills
  • You display high energy and enthusiasm on consistent basis.
  • You get the job done.
  • You make effective decisions
  • You drive and mobilizes others progress toward goals.

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


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

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


What does Attitude mean?
It means that ...
  • You are gracious and professional in your interactions with others.
  • You show by your actions that you trust in the positive intentions of others.
  • You contribute to a positive and fun work environment.
  • You work to eliminate unnecessary work or barriers that get in others' way.
  • You build open and trusting relationships.

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.