Adaptability - 360 Degree Feedback Survey Sample #11

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.

To what extent does [Participant Name] exhibit the following ...

SELECT the rating that best reflects the employee's performance in the areas listed.


What does Adaptability mean?
It means that ...
  • You are proactive and takes steps to prepare for changes in the workplace.
  • You are flexible and open to new ideas and encourages others to value change.
  • You are willing to change ideas or perceptions based on new information or contrary evidence which is presented.
  • You recognize and implement changes to enhance efficiency and effectiveness.
  • You are able to recognize the potential benefits of change, and create an infrastructure which supports change.

To what extent does this person exhibit Adaptability?
Select from one of the ratings below.


What does Action mean?
It means that ...
  • You drive and mobilizes others progress toward goals.
  • You get the job done.
  • You do whatever it takes (within reason) to get the job done.
  • You display high energy and enthusiasm on consistent basis.
  • You work quickly when faced with difficult problems.

To what extent does this person exhibit Action?
Select from one of the ratings below.


What does Leadership mean?
It means that ...
  • You act decisively in implementing decisions.
  • You clearly explain performance expectations and goals to be reached at the beginning of a project, then let others decide how to achieve the goal.
  • You are able to influence others.
  • You demonstrate leadership and courage in critical situations.
  • You are a highly effective supervisor.

To what extent does this person exhibit Leadership?
Select from one of the ratings below.

Decision Making

What does Decision Making mean?
It means that ...
  • You break complex issues into manageable parts and organize them in a systematic way before making decisions
  • You ask for additional information when making critical decisions.
  • You exercise good judgment by making sound and informed decisions.
  • You do not lose sight of the big picture when making decisions
  • You are able to make decisions quickly.

To what extent does this person exhibit Decision Making?
Select from one of the ratings below.


What does Recognition mean?
It means that ...
  • You reinforce and reward employees for accomplishing necessary goals.
  • You recognize the abilities and skills of self and others
  • You readily share credit and gives others opportunity for visibility.
  • You offer recognition in a timely manner.
  • You make people around them feel appreciated and valued.

To what extent does this person exhibit Recognition?
Select from one of the ratings below.

Areas for Development

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