Adaptability - 360 Degree Feedback Survey Sample #10

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.

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.


  • Able to respond to incidents without stopping the workflow.
  • Adjusts plans as needed based on changing conditions.
  • Responds quickly to new information.
  • Handles unexpected events without a loss of productivity.
  • Adjusts strategy when new information is presented.
If [Participant Name] were to make improvements in Adaptability, what are your suggestions for how he/she can improve this?


  • Shows by their actions that they trust in the positive intentions of others.
  • Is gracious and professional in their interactions with others.
  • Contributes to a positive and fun work environment.
  • Builds open and trusting relationships.
  • Treats all people fairly and with respect.
If [Participant Name] were to make improvements in Attitude, what are your suggestions for how he/she can improve this?


  • Effectively organizes resources and plans
  • Sets a high standard for job performance.
  • Listens and responds to issues and problems
  • ...Produce Quality
  • Has great overall performance
If [Participant Name] were to make improvements in Performance, what are your suggestions for how he/she can improve this?

Technology Use/Management

  • Supports employee training and development initiatives regarding implementation of technology.
  • Applies complex rules and regulations to maintain optimal system performance.
  • Uses technology in decision making and problem solving.
  • Understands and is committed to implementing new technologies.
  • Proficient in the use of technical systems and processes.
If [Participant Name] were to make improvements in Technology Use/Management, what are your suggestions for how he/she can improve this?


  • Seeks to reduce institutional roadblocks to information sharing.
  • Develops a sense of trust in subordinates so they can freely interact and share information with others.
  • Forges mutually beneficial relationships between individuals with diverse backgrounds.
  • Creates the conditions for partnerships to grow and develop.
  • Seeks an understanding of diverse functions within the Company.
If [Participant Name] were to make improvements in Partnering/Networking, what are your suggestions for how he/she can improve this?
Overall, please rate the effectiveness of [Participant Name Here].


Areas for Development

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