Professional Reference Check

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A potential CORE Staffing employee has requested your participation in a professional reference check for them.
Please complete the questionnaire below to the best of your knowledge.
Thank you.

Candidate Name *

Facility Name *

City, State

Reference Name *

Title *

Travel Assignment *

Yes

Employment Dates *

Average Patient Ratio *

Number of Beds in Facility *

Would you rehire *

Yes

Provides competent clinical care following facility policies and procedures *

Above Standard

Meets Standards

Below Standard

N/A

Communicates effectively with patients, families and staff *

Above Standard

Meets Standard

Below Standard

N/A

Completes accurate documentation of patient care *

Above Standard

Meets Standard

Below Standard

N/A

Ability to communicate with staff *

Above Standard

Meets Standard

Below Standard

N/A

Flexibility and Adaptability *

Above Standard

Meets Standard

Below Standard

N/A

Overall Professionalism *

Above Standard

Meets Standard

Below Standard

N/A

Attendance/Punctuality: *

Exceeds Expectations

Meets Expectations

Meets Some Expections

Does Not Meet Expectations

Any additional comments:

Would you like to be contacted by a CORE Staffing Healthcare Recruiter? *

Yes

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