360 Feedback Survey Form

A structured 360 feedback survey for collecting confidential performance feedback from managers, peers, direct reports, and self-assessments.

Respondent Information

• Your relationship to the employee
• Your department
  Optional. Used only for reporting and analysis.
• How long have you worked with the employee?
• Confidentiality acknowledgement

Employee Identification

• Employee name
• Employee ID
  Optional if your organization uses employee IDs.
• Review period
• Date of feedback

Competency Ratings

• Overall effectiveness
• Communicates clearly and appropriately for the audience
• Collaborates effectively with others
• Demonstrates ownership and follows through
• Adapts well to change and ambiguity
• Demonstrates leadership or influence when appropriate
• Comments on ratings
  Provide examples of observable behaviors, outcomes, or situations that support your ratings.

Strengths and Development Areas

• Top strengths
  What does this employee do especially well? Include concrete examples.
• Development areas
  What should the employee improve or do differently? Focus on behaviors, not personality.
• Example of positive impact
  Describe a situation where the employee had a positive impact on the team, customer, or project.
• What support would help them grow?

Overall Assessment

• Overall summary
  Summarize the employee's performance in a few sentences.
• Promotion readiness
• Would you recommend this employee for a stretch assignment or leadership opportunity?
• Additional comments
  Use this field for any context not captured above. Please avoid including unnecessary PII.