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Supervisory evaluation was conducted today for the following provisionally employed staff:
Print Name:
On-site observation
Off-site telephone evaluation
Key:
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1. Excellent
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Consistently exceeds job requirements. Clearly above standards
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2. Above Average
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Occasionally exceeds job requirements to a notable degree
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3. Satisfactory
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Consistently meets all job requirements
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4. Needs Improvement
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Must improve to meet job standards
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5. Unsatisfactory
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Consistently does not meet job requirements
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Information provided by:
Relationship to Patient: SELF OTHER (SPECIFY)
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