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HR-Survey > 360-Degree Feedback > Competency Model > Vision Skills
Vision- 360 Degree Feedback Survey Sample #1
360-Degree Feedback Survey October 2025
Instructions:
Surveys Measuring Vision:
[Company] is conducting a 360-Degree Feedback Assessment Survey 1 (4-point scale; Competency Comments)
developed by HR-Survey for selected managers. Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
You have been selected to provide feedback on the employee listed Survey 4 (5-point scale; radio buttons)
above. Your feedback is an important part of our company's Survey 5 (4-point scale; words)
leadership development process and this survey is intended to Survey 6 (4-point scale; words)
gather broad feedback in the core competencies and role Survey 7 (5-point scale; competency comments; N/A)
responsibilities that are important for the on-going success of our Survey 8 (3-point scale; Agree/Disagree words; N/A)
organization. Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
In responding to the questions below, think about your experiences Survey 11 (Single rating per competency)
working with this employee over the last twelve months. The Survey 12 (Slide-bar scale)
effectiveness of this development tool is dependent on your honest, Survey 13 (4-point scale; numbers; floating anchors)
forthright and constructive responses so please bear this in mind as Survey 14 (4-point scale; N/A)
you answer each question. Your responses will be aggregated with
the responses received from others and discussed with the employee
to foster growth and on-going 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.
Sample Result Document: Competencies Included:
Sample Results Vision, Action, Attitude, Management, Project
Management, Analytical, Juggling Multiple
Your feedback is valuable in helping the individual to understand Responsibilities, Achievement, Excellence, Co-worker
how they are perceived and experienced by others and the impact Development, Recognition
their behavior has on people in the organization with whom they
interact. Feedback received also acknowledges strengths and identifies areas for development.
Use the form below to provide your feedback. Each field and comment box requires a response before you can SUBMIT your final
feedback.
Please ensure that your submission is made between November 1 and November 14. The survey will only be available during
these dates.
Thank you for your participation in the survey. We look forward to seeing the analysis of your responses and we are hoping for
100% participation.
Management Team
Vision Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
1. Develops action plans to align his/her work with the goals of the
organization.
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2. Charts a bold course for the department's rapid evolution and
expansion.
3. Creates and executes a strategic vision that drives the company's
growth forward.
4. Inspires individuals to achieve success by clearly communicating the
organization's vision and motivating them to align their personal
goals with this vision.
5. Ensures that work is systematically aligned and coordinated with the
organization's vision.
If [Participant Name] were to make improvements in Vision, what are your suggestions for how he/she can improve this?
Action Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
6. Gets the job done.
7. Changes course to meet the needs of a new situation.
8. Ensures that the team's tasks align with its overall objectives.
9. Acts immediately instead of waiting for someone else to solve the
issue.
10. Creates innovative products and services.
If [Participant Name] were to make improvements in Action, what are your suggestions for how he/she can improve this?
Attitude Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
11. Demonstrates emotional steadiness and optimism even under
pressure.
12. Adjusts leadership style to meet the needs of different individuals
and situations, showing empathy and agility.
13. Views every interaction as an opportunity to grow and refine
perspective.
14. Encourages others to overcome resistance to change.
15. Encourages innovation by emphasizing that every idea is worth
exploring.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?
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Management Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
16. Anticipates potential obstacles and develops contingency plans to
minimize disruption.
17. Helps the team stay focused by clearly communicating shifting
priorities during times of uncertainty or transition.
18. Clarifies key deliverables and dependencies across project phases.
19. Keep staff informed about what is happening in the company
20. Monitors the effectiveness of resource allocation decisions and
makes adjustments as needed.
If [Participant Name] were to make improvements in Management, what are your suggestions for how he/she can improve this?
Project Management Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
21. Establishes the sequence of steps needed to complete the project.
22. Uses appropriate technology to efficiently communicate with team
members.
23. Develops action items, workplans, timelines, and criteria for projects.
24. Identifies the source materials that will be needed.
25. Communicates with the necessary stakeholders if the budget targets
are missed.
If [Participant Name] were to make improvements in Project Management, what are your suggestions for how he/she can
improve this?
Analytical Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
26. Is willing to revise own views when presented with new, credible
information.
27. Implements a variety of data gathering techniques.
28. Seeks new knowledge and skills to enhance analytical thinking.
29. Uses methods to confirm theories with real-world evidence.
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30. Evaluates evidence objectively, regardless of whether it supports or
contradicts current ideas.
If [Participant Name] were to make improvements in Analytical, what are your suggestions for how he/she can improve this?
Juggling Multiple Responsibilities Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
31. Completes multiple tasks simultaneously.
32. Can multitask while performing all of their other responsibilities and
activities.
33. Keeps track of multiple assignments and deadlines.
34. Switches attention to more urgent tasks when necessary.
35. Manages impact of increased traffic flow and freight receipt by
detailed planning of controllables and by anticipating and reacting
positively to uncontrollables.
If [Participant Name] were to make improvements in Juggling Multiple Responsibilities, what are your suggestions for how
he/she can improve this?
Achievement Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
36. Rapidly completes tasks and assignments.
37. Driven to complete assignments on time.
38. Is determined to complete tasks regardless of obstacles that may
occur.
39. Driven to complete goals despite obstacles that may arise.
40. Completes work to given time frame and to budget
If [Participant Name] were to make improvements in Achievement, what are your suggestions for how he/she can improve this?
Excellence Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
41. Takes a lot of pride in their work.
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42. Demonstrates the analytical skills to do their job.
43. Keeps themselves and others focused on constant improvement.
44. Is planful and organized.
45. Demonstrates the functional or technical skills necessary to do their
job.
If [Participant Name] were to make improvements in Excellence, what are your suggestions for how he/she can improve this?
Co-worker Development Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
46. Adapts coaching and mentoring approach to meet the style or needs
of individuals
47. Takes immediate action on poor performance
48. Works to identify root causes of performance problems
49. Gives others development opportunities through project
assignments and increased job responsibilities
50. Provides ongoing feedback to co-workers on their development
progress
If [Participant Name] were to make improvements in Co-worker Development, what are your suggestions for how he/she can
improve this?
Recognition Meets
Needs Minimum Is Role
Improvement Standards Proficient Model
51. Recognizes employees through public announcements or progress
boards in common areas.
52. Highlights specific contributions, demonstrating to employees how
their efforts support department goals and drive success.
53. Engages in employee recognition activities.
54. Is mindful of diversity in contributions, recognizing not only visible
successes but also behind-the-scenes work that supports the team.
55. Is transparent in communication about recognition programs and
awards.
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If [Participant Name] were to make improvements in Recognition, what are your suggestions for how he/she can improve this?
56. What are [Participant Name Here]'s greatest strengths demonstrated this year?
57. What are [Participant Name Here]'s areas for development?
58. Please give any final comments or suggestions for [Participant Name Here]'s assessment.
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