Vision- 360 Degree Feedback Survey Sample #9

360 Feedback Survey

Assessments Measuring Vision:
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.

Sample Result Document:
Sample Results
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.


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


Definite Strength Meets Standards Needs Development N/A
  1. Recognizes the abilities and skills of self and others
  1. Recognizes individuals for a specific outstanding achievement.
  1. Finds opportunities to recognize others.
  1. Recognizes team members who offer a significant contribution to a project.
  1. Offers recognition in a timely manner.

Passion To Learn

Definite Strength Meets Standards Needs Development N/A
  1. Holds self and associates accountable for goal achievement.
  1. Inspires others to learn new things.
  1. Recognizes own areas for development and consciously seeks assignments that will provide practice in areas of developmental need.
  1. Exhibits willingness to upgrade skills through additional training and education.
  1. Enjoys learning new skills and techniques.

Professional Development

Definite Strength Meets Standards Needs Development N/A
  1. Demonstrate enthusiasm and a willingness to learn new skills and knowledge
  1. Encourages employees to take courses relevant to their job.
  1. Seeks opportunities for professional development.
  1. Seeks opportunities for continuous learning.
  1. Keep themselves up-to-date of technical/professional issues

Establishing Focus/Direction

Definite Strength Meets Standards Needs Development N/A
  1. Excellent at managing time.
  1. Stays focused even when under pressure and stress.
  1. Makes sure that employees understand and identify with the team's mission.
  1. Helps guide employees with prioritizing tasks.
  1. Aligns the department's goals with the goals of the organization.


Definite Strength Meets Standards Needs Development N/A
  1. Encourages employees to produce the best quality products.
  1. Encourages others to produce the highest quality work products.
  1. Reflects on what is working and what could be improved.
  1. Encourages others to achieve high quality standards.
  1. Always strives to produce the highest quality work products.


Definite Strength Meets Standards Needs Development N/A
  1. Develops new products and services.
  1. Solves problems with insight and understanding.
  1. Fosters a creative and innovative work environment.
  1. Searches for opportunities and innovative ways to improve the organization.
  1. Challenges current procedures to develop other alternatives.

Results Oriented

Definite Strength Meets Standards Needs Development N/A
  1. Inspires and motivates co-workers to be productive and energetic at work
  1. Demonstrates the personal confidence to "stay the course," even when faced with difficulty
  1. Does not become distracted by non-issues or interruptions.
  1. Encourages a high-energy, fun work environment and coaches others on how to do the same
  1. Works toward achievement of goals even when confronted with obstacles.


Definite Strength Meets Standards Needs Development N/A
  1. Demonstrates the functional or technical skills necessary to do their job.
  1. Keeps themselves and others focused on constant improvement.
  1. Can be counted on to add value wherever they are involved.
  1. Produces high quality work.
  1. Is planful and organized.


Definite Strength Meets Standards Needs Development N/A
  1. Holds herself / himself accountable to goals / objectives
  1. Responsible for setting the vision of the department.
  1. ...takes personal responsibility for results.
  1. Acts as a resource without removing individual responsibility.
  1. Behavior is ethical and honest.


Definite Strength Meets Standards Needs Development N/A
  1. Maintains infrastructure to support partnerships and networks.
  1. Supports and encourages relationships that are created by diverse team members.
  1. Develops a sense of trust in subordinates so they can freely interact and share information with others.
  1. Builds alliances between departments and teams.
  1. Creates the conditions for partnerships to grow and develop.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

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