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)

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.

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. Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
  1. Able to work effectively with new people and new teams.
  1. Develops insights and applies innovative solutions to projects and problems.
  1. Performs a wide range of tasks, responds to changes in direction and priorities and accepts new challenges, responsibilities, and assignments.
  1. Able to quickly learn new ways of performing their job.

Supervisory Skills

Agree Unsure Disagree N/A
  1. Delegates effectively.
  1. Treats all staff equitably.
  1. Resolves personnel problems quickly and effectively.
  1. Is aware of the unique strengths of each employee.
  1. Provides constructive, ongoing feedback.


Agree Unsure Disagree N/A
  1. Allows subordinates to use their own methods and procedures.
  1. Delegates authority and responsibility to subordinates and holds them accountable for their actions.
  1. Encourages and empowers subordinates to use initiative in achieving goals and objectives.
  1. Defines the roles, responsibilities, required actions, and deadlines for team members.
  1. Delegates tasks, responsibilities, and accountability as appropriate to the level of employee.


Agree Unsure Disagree N/A
  1. Encourages employees to produce the best quality products.
  1. Encourages others to achieve high quality standards.
  1. Holds employees accountable for their quality of work.
  1. Encourages others to produce the highest quality work products.
  1. Corrects issues in a timely manner.

Change Management

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

Managing Risk

Agree Unsure Disagree N/A
  1. Avoids maintaining the status quo (or standard operating procedures) when addressing new and influential situations.
  1. Seeks to retain the best and brightest employees.
  1. Knows how to obtain desired results with minimal losses.
  1. Seeks to maintain the long-term viability of the Company.
  1. Works within constraints of the organization.


Agree Unsure Disagree N/A
  1. Keeps informed of various regulations and procedures.
  1. Understands the applicable regulations and laws that impact our business.
  1. Maintains a state of readiness to address new and changing regulations and procedures.
  1. Addresses issues quickly before they develop into major problems.
  1. Performs audits regularly, or without notice, to ensure proper compliance with regulations.

Organizational Fluency

Agree Unsure Disagree N/A
  1. Effective in communicating with others within the organization.
  1. Able to deal with sensitive issues with tact and professionalism.
  1. Anticipates problems that may affect the department.
  1. Adept at navigating within the culture of the department.
  1. Gets things done through the department.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

  4. Please give any final comments or suggestions for 's assessment.