Quarterly Performance Review Survey: Survey Example

In this survey example, a twelve item survey is administered to employees on a quarterly basis. The responses of each quarter are shown in a table form with green checkmarks representing the previous responses and the typical response ovals representing the current response to be made.

Popup comment boxes are also used with this survey example. The comment boxes will appear only on the extreme ends of the rating scale. If you wish to make a comment for a response that is towards the middle of the rating scale, then you can click on the appropriate button in the green section of the questionnaire form.

The responses that you need to make (for the 3rd quarter) are shown below highlighted in yellow.


Your feedback is an important part of [Company]'s improvement plan. This 360-Degree Assessment tool was developed as a way to gather broad performance feedback in a variety of selected areas that are important for our ongoing success. Please think about the work you have done with this individual during the past three months when completing the assessment form. The results will be merged with those of others giving feedback and presented to all of us to guide us in our ongoing development. It is anticipated that it will take approximately 10 minutes to complete this assessment.

Please provide feedback using the form below. When you have finished, press the SUBMIT button at the bottom of the form. If you are not able to respond to an item, or, if the item is not applicable, check the appropriate box in the green area on the right and go on to the next item. If you rate an individual as needing a lot of development or as a role model in certain areas, you will be prompted for a comment. Please try to provide a helpful comment. If you are not being prompted to make a comment and want to leave one for a particular attribute, there is also a button to check in the green area on the right that will also allow you to leave a comment.

Your responses from the previous quarter are shown on the form below using green checkmarks. Please make sure you enter a response for this quarter as well

Additional Comments:

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