Teamwork- 360 Degree Feedback Survey Sample #11

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.

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

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


What does Teamwork mean?
It means that ...
  • You create a culture that fosters and values collaboration.
  • You actively participates in the work of teams; seek and listen to others' contributions
  • You communicate a clear message that teamwork and collaboration are expected.
  • You foster teamwork rather than individual competition
  • You encourage collaboration with other departments.

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


What does Initiative mean?
It means that ...
  • You take decisive action to address problems, following up with relevant team members and coaching them on how to improve.
  • You immediately work to complete goals well before your deadline.
  • You coach others to foster an environment which can adapt quickly and willingly to rapid change.
  • You take action without being asked.
  • You prepare for unexpected contingencies.

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

Interpersonal Skills

What does Interpersonal Skills mean?
It means that ...
  • You use tact, compassion, and sensitivity in interactions with others.
  • You strive for win/win solutions
  • You demonstrate willingness to work with others.
  • You use knowledge and charisma rather than position, power, or coercion to influence others
  • You successfully resolve conflicts and grievances to a win-win solution.

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

Emotional Intelligence

What does Emotional Intelligence mean?
It means that ...
  • You are able to control your own emotions.
  • You are able to express yourself clearly.
  • You accurately perceive the emotional reactions of others.
  • You are attentive to emotional cues and interprets others' feelings correctly.
  • You are able to understand others' points of view.

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

Global Perspective

What does Global Perspective mean?
It means that ...
  • You form strong client relationships with international partners.
  • You understand how cultures differ and how these differences impact work behavior.
  • You develop both the cultural awareness and business skills to grow our business in all countries, and work effectively across borders with employees, customers, and shareowners.
  • You analyze global issues/problems that are having a large impact on the Company.
  • You consider customers point of view when making decisions.

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

Areas for Development

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