Adaptability - 360 Degree Feedback Survey Sample #12

360 Feedback Survey

Instructions

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.

Adaptability

• Is proactive and takes steps to prepare for changes in the workplace.
• Willing to change ideas or perceptions based on new information or contrary evidence which is presented.
• Learns from personal experiences and/or mistakes.
• Ability to recognize the potential benefits of change, and create an infrastructure which supports change.
• Develops insights and applies innovative solutions to projects and problems.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Integrity

• Establishes relationships of trust, honesty, fairness, and integrity.
• Develops trust and confidence from others.
• Demonstrates sincerity in actions with others.
• Fosters a high standard of ethics and integrity.
• Protects the integrity and confidentiality of information

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Cultural Awareness

• Seeks out different viewpoints and benefits from different perspectives.
• Shows respect in daily interactions
• Treats others with dignity and respect.
• Respects others regardless of age, race, gender, nationality, or disability.
• Fosters a diverse workforce free from discrimination and harassment.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Administrative Skill

• Enthusiastic about taking on challenging projects.
• High attention to detail.
• Has strong technical/computer skills.
• Strong organizational skills to keep the workspace and department in order
• Able to develop, justify and present a budget.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Results Oriented

• Demonstrates the personal confidence to "stay the course," even when faced with difficulty
• Encourages a high-energy, fun work environment and coaches others on how to do the same
• Inspires and motivates co-workers to be productive and energetic at work
• Explains the "whys" behind organizational objectives
• Helps others when free-time is available.

Needs Improvement		Fully Proficient		Excels/ Role Model
Click this box to make your rating

Comments:

Strengths


Areas for Development


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