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)
Survey 10 (Comment boxes only)
Survey 11 (Single rating per competency)
Survey 12 (Slide-bar scale)

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.

Sample Result Document:
Sample Results
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. Works effectively during periods of change.
  1. Acts decisively in frequently changing and uncertain environment.
  1. Willing to try new ideas.
  1. Able to adapt to new situations.
  1. Identifies new opportunities to achieve goals

Self Management

Agree Unsure Disagree N/A
  1. Analyzes own reactions on the spot to ensure that communication does not appear to be driven by anger.
  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. Steps away from a situation to process appropriate response.
  1. Analyzes interpersonal problems instead of reacting to them.

Cultural Awareness

Agree Unsure Disagree N/A
  1. May advocate for others with different cultural backgrounds.
  1. Is open and honest in communications with individuals from other cultures.
  1. Seeks out different viewpoints and benefits from different perspectives.
  1. Respects others regardless of age, race, gender, nationality, or disability.
  1. Recognizes and values individual and cultural differences.


Agree Unsure Disagree N/A
  1. Asks the "right" questions to size up or evaluate situations.
  1. Identifies opportunities for progress and innovation.
  1. Uses appropriate techniques to solve problems.
  1. Analyzes data and information from several sources and arrives at logical conclusions.
  1. Selects the appropriate techniques for analysis.

Time Management

Agree Unsure Disagree N/A
  1. Deals effectively with interruptions.
  1. Leaves time in the schedule for unplanned contingencies.
  1. Sets a good balance between work and family life.
  1. Completes high-priority work within required timelines.
  1. Avoids distractions in the workplace.


Agree Unsure Disagree N/A
  1. Makes sure goals and objectives are clearly and thoroughly explained and understood.
  1. Clearly defines work objectives for employees.
  1. Seeks to reduce ambiguity in messaging and documents.
  1. Provides a clear vision for the future.
  1. Uses appropriate grammar and tense in communications.


Agree Unsure Disagree N/A
  1. Delivers on promises made.
  1. Demonstrates congruence between statements and actions.
  1. Consistently keeps commitments.
  1. Builds and maintains the trust of others.
  1. Communicates an understanding of the other person's interests, needs and concerns.

  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.