360-Degree Nurse Performance Feedback Form
Provide structured feedback on a nurse’s performance, strengths, and development areas for the review period using the same title throughout the form.
Nurse Identification
Nurse Full Name
*
First Name
Middle Name
Last Name
Unit / Department
*
Job Title / Role
*
Review Period
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reviewer and Feedback Overview
Reviewer Name
*
Relationship to Nurse
*
Peer Nurse
Charge Nurse
Supervisor
Physician
Other Clinical Colleague
Overall Performance Rating
*
1
2
3
4
5
Overall Feedback Summary
*
Strengths and Improvement Priorities
Key strengths observed
*
Areas for improvement
*
Most impactful development priority
*
Please Select
Communication with team
Time management and prioritization
Documentation and handoff quality
Collaboration and professionalism
Adaptability under pressure
Other
Comments or examples supporting your feedback
Submit Feedback
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