Adaptability - 360 Degree Feedback Survey Sample #9

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)

Thank you for providing feedback for the recipient above. As you respond, please draw on your first-hand experience with this individual in the past 12 months. Rate each item using the scale shown. If you don't feel you have enough first-hand information to rate a certain item, please choose the Not Applicable option. Comments can be very helpful; at a minimum where you give a particularly high or low rating, please share your reasons in the comment section for that competency. Your responses will be compiled with feedback from others and presented to the recipient to help guide their ongoing 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.


Definite Strength Meets Standards Needs Development N/A
  1. Learns from personal experiences and/or mistakes.
  1. Able to quickly learn new ways of performing their job.
  1. Develops insights and applies innovative solutions to projects and problems.
  1. Flexible and open to new ideas and encourages others to value change.
  1. Ability to recognize the potential benefits of change, and create an infrastructure which supports change.

Self Management

Definite Strength Meets Standards Needs Development N/A
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Sets an example for associates during stressful periods by maintaining a positive, can-do attitude.
  1. Steps away from a situation to process appropriate response.

Emotional Intelligence

Definite Strength Meets Standards Needs Development N/A
  1. Is able to control their own emotions.
  1. Able to understand others' points of view.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.
  1. Is able to express themselves clearly.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Sets and maintains high standards for self and others.
  1. Recognizes and values good performance.
  1. Obtains commitment from employees regarding completion of tasks.
  1. Is consistent in disciplinary/corrective actions.
  1. Measures performance against goals and objectives.


Definite Strength Meets Standards Needs Development N/A
  1. Achieves established goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Achieves goals.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Goal Setting

Technology Use/Management

Definite Strength Meets Standards Needs Development N/A
  1. Supports employee training and development initiatives regarding implementation of technology.
  1. Uses technology in decision making and problem solving.
  1. Understands and is committed to implementing new technologies.
  1. Adopts the implementation of new technology into the workplace.
  1. Applies complex rules and regulations to maintain optimal system performance.


Definite Strength Meets Standards Needs Development N/A
  1. Encourages me to take on greater responsibility.
  1. Organizes and schedules events, activities, and resources.
  1. Establishes goals and objectives.
  1. Assures [Company] principles are understood, employed & pursued.
  1. Sets long-term and short-term goals.


Definite Strength Meets Standards Needs Development N/A
  1. Conducts regular performance appraisals and feedback.
  1. Addresses employee behavior problems effectively.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Helps employees to maintain high personal standards.
  1. Provides clear, motivating, and constructive feedback.

Strategic Insight

Definite Strength Meets Standards Needs Development N/A
  1. Anticipates business cycles and trends and makes adjustments in a timely manner.
  1. Identifies potential problems before they become critical incidents.
  1. Formulates strategies and action plans to ensure successful completion of goals and objectives.
  1. Understands the Company's strengths and weaknesses and uses this information to create optimal solutions to problems.
  1. Analyzes records and reports to obtain insight into potential issues and trends.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Adept at navigating within the culture of the department.
  1. Understands the current organizational culture.
  1. Anticipates problems that may affect the department.
  1. Able to use corporate politics to advance department objectives.
  1. Able to explain departmental policies and procedures to others.

  1. Overall, please rate the effectiveness of .

  2. Strengths

  3. Areas for Development

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