Adaptability - 360 Degree Feedback Survey Sample #9

360 Feedback Survey

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)

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.

Sample Result Document:
Sample Results
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. Adjusts priorities to changing business goals.
  1. Learns from personal experiences and/or mistakes.
  1. Able to adapt to changes in technology and processes.
  1. Works effectively in dynamic and changing work environments.
  1. Willing to change ideas or perceptions based on new information or contrary evidence which is presented.

Self Management

Definite Strength Meets Standards Needs Development N/A
  1. Consciously controls own negative emotions in order to keep team morale up.
  1. Is aware of personal impact on others and adjusts behavior to create a positive leadership presence.
  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. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.

Emotional Intelligence

Definite Strength Meets Standards Needs Development N/A
  1. Is able to control their own emotions.
  1. Is able to manage their own emotions.
  1. Helps employees to resolve conflicts, communicate clearly, and work together to solve problems.
  1. Accurately perceives the emotional reactions of others.
  1. Helps to make decisions and solve problems using knowledge about how others will react in certain situations.

Managing Performance

Definite Strength Meets Standards Needs Development N/A
  1. Is consistent in disciplinary/corrective actions.
  1. Informs team members how their performance compares to stated goals.
  1. Reviews job performance shortly after completion of tasks.
  1. Makes sure the team's goals are met.
  1. Ensures team members receive rewards for positive performance accomplishments.


Definite Strength Meets Standards Needs Development N/A
  1. Achieves established goals.
  1. Understands & contributes to development of strategic goals.
  1. Makes sure that team members have a clear idea of our group's goals.
  1. Conducts timely follow-up; keeps others informed on a need to know basis.
  1. Establishes and documents goals and objectives.

Technology Use/Management

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


Definite Strength Meets Standards Needs Development N/A
  1. Assures [Company] principles are understood, employed & pursued.
  1. Effectively organizes resources and plans
  1. Organizes and schedules events, activities, and resources.
  1. Able to organize work.
  1. Sets long-term and short-term goals.


Definite Strength Meets Standards Needs Development N/A
  1. Provides clear, motivating, and constructive feedback.
  1. Meets regularly with employees to coach them on areas that will enhance their performance
  1. Conducts regular performance appraisals and feedback.
  1. Helps employees to understand responsibilities, authority, and expectations.
  1. Coaches employees in how to strengthen knowledge and skills to improve work performance.

Strategic Insight

Definite Strength Meets Standards Needs Development N/A
  1. Identifies potential problems before they become critical incidents.
  1. Identifies root causes of problems.
  1. Communicates vision for the department and company.
  1. Formulates policies and strategies for addressing the Company's important challenges.
  1. Anticipates business cycles and trends and makes adjustments in a timely manner.

Organizational Fluency

Definite Strength Meets Standards Needs Development N/A
  1. Able to use corporate politics to advance department objectives.
  1. Able to explain departmental policies and procedures to others.
  1. Gets things done through the department.
  1. Anticipates problems that may affect the department.
  1. Able to deal with sensitive issues with tact and professionalism.

  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.