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.


  • Builds relationships across boundaries and with key stakeholders by developing informal and formal networks.
  • Actively and openly participates in group meetings.
  • Shares credit for accomplishments with team members
  • Willingly share their technical expertise
  • Provides assistance and support to other team members when needed
If [Participant Name] were to make improvements in Teamwork, what are your suggestions for how he/she can improve this?

Professional Development

  • Seeks opportunities for professional development.
  • Encourages employees to take courses relevant to their job.
  • Keep themselves up-to-date of technical/professional issues
  • Contributing fully to the extent of their skills
  • 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

  • Creates a sense of urgency among the store team members to complete activities, which drive sales.
  • Takes immediate action toward goals.
  • Conveys strong sense of own pride in Company to associates by creating a shared vision around sales and customer service.
  • Maintains persistence and dedication to achieving results.
  • 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

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


  • Expresses the Company vision in a way that is easily understood and adopted by employees.
  • Demonstrates consistency between words and actions
  • Clearly articulates a vision for his/her work and inspires others to support it
  • Leads employees in new directions.
  • Communicates the vision and strategy of [Company]
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.