Flexibility - 360 Degree Feedback Survey Sample #8

Questionnaires Measuring Flexibility:
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)

You have been selected to provide feedback for the manager listed above. Your feedback is an important part of 's leadership development process. This tool is intended to gather broad feedback in the core competencies and role responsibilities that are important for the on-going success of our organization.

In responding to the assessment form, please think about your experiences working with this individual during the last six to twelve months. Your responses will be merged with other people's feedback and presented to to guide them in their on-going development. Comments will be shared anonymously, as written, with the manager.

Method of use: As part of the review process, managers will receive feedback from peers and staff. It is recognized that not all participants will be able to assess an individual's performance in all areas. The feedback received will be utilized as input to the manager's performance and on-going development plan.

You may sign out at any time by pressing the Save button at the end of the form and then closing your browser. You may return later to pick up where you left off. When you are done, press the Complete button.

When clicking your selection below, try to best fit the manager's actual behaviors to the scale provided.

If you are not sure, or unable to assess, select "Not Applicable" (N/A) option.

Please complete your response by .


Agree Unsure Disagree N/A
  1. Adapts to new organizational structures, policies, or procedures.
  1. Willing to try new ideas.
  1. Acts decisively in frequently changing and uncertain environment.
  1. Able to adapt to new situations.
  1. Is open to alternative ways to accomplish goals

Self Management

Agree Unsure Disagree N/A
  1. Analyzes interpersonal problems instead of reacting to them.
  1. Deals with conflict by controlling own emotions by listening, being flexible, and sincere in responding.
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  1. Steps away from a situation to process appropriate response.
  1. Consciously controls own negative emotions in order to keep team morale up.

Cultural Awareness

Agree Unsure Disagree N/A
  1. Respects others regardless of age, race, gender, nationality, or disability.
  1. Maintains an inclusive work environment that maximizes the talents of others in achieving goals.
  1. Seeks out different viewpoints and benefits from different perspectives.
  1. Treats others with dignity and respect.
  1. Recognizes and values individual and cultural differences.


Agree Unsure Disagree N/A
  1. Identifies the root cause of a problem.
  1. Can effectively interpret and analyze data.
  1. Uses appropriate techniques to solve problems.
  1. Asks the "right" questions to size up or evaluate situations.
  1. Actively seeks constructive feedback from others.

Time Management

Agree Unsure Disagree N/A
  1. Prioritizes tasks to identify immediate and long-term objectives.
  1. Leaves time in the schedule for unplanned contingencies.
  1. Makes time for developing plans and schedules.
  1. Sets a good balance between work and family life.
  1. Deals effectively with interruptions.


Agree Unsure Disagree N/A
  1. Clarifies problems and their causes to help employees correct them.
  1. Maintains clarity in goals and objectives.
  1. Communicates ideas and facts clearly and effectively in writing.
  1. Avoids stating unclear or conflicting goals.
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.


Agree Unsure Disagree N/A
  1. Demonstrates congruence between statements and actions.
  1. Works in a way that makes others want to work with her/him.
  1. Delivers on promises made.
  1. Consistently keeps commitments.
  1. Builds and maintains the trust of 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.