Adaptability - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Adaptability:
Survey 1 (4-point scale; Competency Comments)
Survey 2 (4-point scale; Competency Comments)
Survey 3 (5-point scale; Competency Comments)
Survey 4 (5-point scale; radio buttons)
Survey 5 (4-point scale; words)
Survey 6 (4-point scale; words)
Survey 7 (5-point scale; competency comments; N/A)
Survey 8 (3-point scale; Agree/Disagree words; N/A)
Survey 9 (3-point scale; Strength/Development; N/A)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of '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 six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Sample Result Document:
Sample Results
Method of use: As part of the review process, managers will receive feedback from peers and staff. 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 manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Develops insights and applies innovative solutions to projects and problems.
  1. Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
  1. Able to adapt to changes in technology and processes.
  1. Able to quickly learn new ways of performing their job.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.

Supervisory Skills

Agree Unsure Disagree N/A
  1. Is aware of the unique strengths of each employee.
  1. Encourages employees to achieve their full potential.
  1. Maintains good working relationships with employees.
  1. Appropriately recognizes and rewards employees.
  1. Provides constructive, ongoing feedback.


Agree Unsure Disagree N/A
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Entrusts subordinates with important tasks.
  1. Allows subordinates to use their own methods and procedures.
  1. Assigns tasks to create learning opportunities for the employees.


Agree Unsure Disagree N/A
  1. Holds employees accountable for their quality of work.
  1. Encourages others to achieve high quality standards.
  1. Reflects on what is working and what could be improved.
  1. Always strives to produce the highest quality work products.
  1. Encourages employees to produce the best quality products.

Change Management

Agree Unsure Disagree N/A
  1. Works cooperatively with others to implement changes.
  1. Effective in dealing with ambiguous and challenging situations.
  1. Adopts changes to set and example for others to follow.
  1. Supports new initiatives for organizational changes to improve effectiveness.
  1. Effective in implementing new organizational vision and values.

Managing Risk

Agree Unsure Disagree N/A
  1. Performs regular risk analyses to minimize adverse outcomes.
  1. Accurately perceives potential risks in the workplace and initiates preventative measures.
  1. Accurately perceives potential risks in the workplace.
  1. Creates informative guides regarding potential risks and risky behaviors.
  1. Knows how to obtain desired results with minimal losses.


Agree Unsure Disagree N/A
  1. Complies with trade agreements affecting international companies.
  1. Keeps up-to-date with legislation affecting employees.
  1. Performs regular compliance audits.
  1. Creates and maintains necessary regulatory documentation.
  1. Creates documents and reports as needed to maintain compliance with regulations.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Able to explain departmental policies and procedures to others.
  1. Able to use corporate politics to advance department objectives.
  1. Anticipates problems that may affect the department.
  1. Understands departmental policies and procedures.
  1. Is aware of other organizational cultures to compare/contrast with the current organizational culture.

  1. Overall, please rate the effectiveness of [Participant Name Here].

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for [Participant Name Here]'s assessment.