Teamwork- 360 Degree Feedback Survey Sample #10

360 Feedback Survey

Assessments Measuring Teamwork:
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.


  • Actively and openly participates in group meetings.
  • Encourages collaboration with other departments.
  • Applies knowledge of team behavior to help achieve organizational goals and objectives.
  • Fosters respect and understanding among team members
  • Coaches team members
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

Professional Development

  • Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  • Quickly acquire and apply new knowledge and skills when needed
  • Keep themselves up-to-date of technical/professional issues
  • Encourages employees to take courses relevant to their job.
  • Seeks opportunities for continuous learning.
If [Participant Name] were to make improvements in Professional Development, what are your suggestions for how he/she can improve this?

Commitment To Result

  • Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  • Encourages commitment in others to obtain results.
  • Coordinates all department activities into a cohesive team effort.
  • Takes immediate action toward goals.
  • Able to focus on a task even when working alone.
If [Participant Name] were to make improvements in Commitment To Result, what are your suggestions for how he/she can improve this?

Strategic Focus

  • Communicates goals and objectives to employees.
  • Understands their role within the organization.
  • Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
  • Focuses attention on treating the causes of problems rather than simply addressing the symptoms.
  • Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
If [Participant Name] were to make improvements in Strategic Focus, what are your suggestions for how he/she can improve this?


  • Demonstrates consistency between words and actions
  • Works to support the strategy of [Company]
  • Behaves in a way that is consistent with business values & code of conduct
  • Persuades others to follow the Company's vision.
  • Develops action plans to align his/her work with the goals of the organization
If [Participant Name] were to make improvements in Vision, 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.