Vision- 360 Degree Feedback Survey Sample #10

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.

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.


  • Communicates the vision and strategy of [Company]
  • Creates a common vision for others.
  • Understands the vision of the Company and promotes it ahead of any self-interests.
  • Communicates a vision of where the Company needs to be in the future.
  • 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?

Strategic Focus

  • Sustains or achieves a competitive advantage for the organization by analyzing the best practices and lessons learned from other organizations.
  • Understands their role within the organization.
  • Understands & contributes to development of strategic goals.
  • Monitors performance of each market within the Area, utilizing reports to ensure sales growth, cost management, and profitability targets are met.
  • Creates plans to develop and promote organizational and area strengths, as well as to address weaknesses.
If [Participant Name] were to make improvements in Strategic Focus, what are your suggestions for how he/she can improve this?

Client Focus

  • Maintains strong relationships with clients.
  • Looks for opportunities that have a positive impact on Clients.
  • Ensures client commitments and requirements are met or exceeded
  • Forms strong client relationships
  • Satisfies client needs.
If [Participant Name] were to make improvements in Client Focus, what are your suggestions for how he/she can improve this?


  • Ability to establish realistic goals.
  • Organizes and schedules events, activities, and resources.
  • Able to organize work.
  • Encourages me to take on greater responsibility.
  • Assures [Company] principles are understood, employed & pursued.
If [Participant Name] were to make improvements in Objectives, what are your suggestions for how he/she can improve this?

Commitment To Result

  • Coordinates all department activities into a cohesive team effort.
  • 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.
  • Committed to the team.
  • 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?
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.