Sample 360-Degree Feedback Questionnaire 17

ABC Global 360-Degree Feedback

You are providing feedback to:

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of Demo Client's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last twelve months. Your responses will be merged with other's feedback to guide them in their on-going development. Comments will be shared anonymously as written.

Method of use: As part of the annual appraisal process, leaders receive feedback from peers, subordinates, customers and supervisors. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the individual's annual appraisal and development plan.

Performance Rating Guide:
Excels/Role model. Results consistently exceed expectations. Makes significant contributions well beyond requirements. Outpaces the majority of peers.
Fully Proficient. Results are fully and consistently on target. Makes a valuable contribution. Is fully competent. This level describes performance of the majority of employees.
Needs improvement. Improvement clearly needed. Is inconsistent in performance and requires excessive supervision and support. An action plan for improvement in this area needed.

Below each item is a small box that contains the statement: "Click this box to make your rating". Each box has a rating scale with three anchors (see above). Click the box along the scale where you feel the rating should be made. You may also drag the mouse over the rating scale to make your rating.


Closing Comments

Note: When you enter text comments into the boxes below, please focus your comments on work behaviors and styles. The comments that you type will be viewed by the individual receiving the feedback. Do not enter personal information about yourself unless you want this individual to know you are the author of these comments.

Describe the greatest strengths of [Ratee] with regard to overall effectiveness in performing his current responsibilities.

Describe the most important things [Ratee] could improve upon in order to increase overall effectiveness in performing his current responsibilities.