Vision- 360 Degree Feedback Survey Sample #11

360 Feedback Survey

Instructions

We appreciate you taking the time to provide valuable feedback for the individual mentioned above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Your insights are crucial in offering a comprehensive evaluation. Please rate each item using the scale provided. If you find that you do not have sufficient first-hand knowledge to rate a particular item, select the Not Applicable option.

In addition to the ratings, we encourage you to include comments where possible. These comments are particularly useful when you give a very high or very low rating, as they provide context and clarity regarding your assessment. Explaining your reasons in the comment section helps ensure that your feedback is constructive and actionable.

Your responses, combined with feedback from other contributors, will be compiled and presented to the individual. This collective feedback aims to support their continuous growth and development by highlighting strengths and identifying areas for improvement. Your thoughtful participation is essential in helping them achieve their full potential.

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.

Edit this Survey

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Vision

What does Vision mean?
It means that ...

• You ensure that work is systematically aligned and coordinated with the organization's vision.
• You turn the department's vision into defined objectives and a strategic framework.
• I articulate the vision in a way that resonates with diverse stakeholders, adapting language to audience needs.
• You influence the attitudes and behaviors of subordinates to match the department's vision.
• I use consistent language and metaphors when describing the department's purpose and direction.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Cultural Awareness

What does Cultural Awareness mean?
It means that ...

• You participate in diversity and inclusion initiatives to model respectful engagement.
• You maintain an inclusive work environment that maximizes the talents of others in achieving goals.
• You communicate with others without the influence of racism.
• You maintain professional decorum and avoid culturally insensitive language or behavior.
• You value the opinions of diverse groups and individual.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Delegation

What does Delegation mean?
It means that ...

• You recognize individual expertise to delegate tasks in a way that maximizes team performance and workflow efficiency.
• You communicate expected/desired outcomes.
• I match responsibilities with the employee's ability to deliver high-quality results.
• I identify interdependencies between tasks are delegated strategically.
• You balance employee skill level with opportunities for professional development in task assignments.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Partnering/Networking

What does Partnering/Networking mean?
It means that ...

• You establish regular check-ins to ensure alignment and address any emerging issues.
• I manage effective partnerships between public, private, and non-profit sectors.
• I create strategic partnerships when resources are limited.
• I aim to foster and sustain relationships rooted in trust and commitment.
• You willingly participate on committees and project teams.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Adaptability

What does Adaptability mean?
It means that ...

• You develop insights and apply innovative solutions to projects and problems.
• I am able to work on various customer accounts which have different needs/goals.
• I pursue alternate courses of action as necessary.
• You work well in periods of rapid change.
• You learn new ways to perform tasks; adopts new skill sets as required.

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

Not Applicable or Unable to Judge

Poor does not perform to expected standards; often unable to complete tasks; does not seek help or advice

Minimal completes tasks only when pressured to do so; is satisfied with minimal progress; only does what is required

Average completes tasks easily; seeks to obtain maximal performance; willing to seek advice and help when needed

Role Model is a role model for others to follow; goes above and beyond what is expected; helps others

Strengths


Areas for Development


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