CCMS PERFORMANCE APPRAISAL
Name: Date: ___________
Clinical Location: Facility:
Please complete the
following evaluation on the above named employee. Thank you for your assistance
in the evaluation process.
Clinical position
held in your facility:
|
Performance
Evaluation |
Outstanding |
Highly
Effective |
Effective |
Improvement
Needed |
Unacceptable |
|
Quality of Work |
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Quantity of Work |
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Attitude |
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Professional Conduct |
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Adaptability to Work
Situations |
|
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Dependability |
|
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Cooperation |
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Ability to Get Along With Others |
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Ability to Accept
Leadership Role |
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Attendance and Punctuality |
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Personal Appearance |
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|
Please provide additional
comments and goals for the next year on reverse side.
Evaluator’s
Signature: Title:
Employee Signature: Date:_
