Clinical: Employee Self Evaluation
Please rate your performance.
Email address *
First and Last Name *
Position: *
Date of Self-Evaluation *
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Customer service, patient interactions, and meeting patient goals. Scheduled visits are timely with minimal missed visits. *
Unacceptable
Exceptional
Accountability for following state & federal regulations, policies, and procedures. Observes ethical and professional conduct at all times i.e respect and punctuality. Integrity in timekeeping, patient visits, and documentation. *
Unacceptional
Exceptional
Performs clinical skills accurately, effectively, and competently. Adjusts and modifies provision of care based on patient's needs. *
Unacceptable
Exceptional
Observes proper chain of command in reporting referral system. Shows willingness to perform assigned tasks. Verbalizes own strengths, weaknesses, and limitations. *
Unacceptable
Exceptional
Utilizes critical thinking and sound decision making. Manifests effective time management and workload organization to facilitate patient care. *
Unacceptable
Exceptional
What are your short-term goals at Affinity? *
What are your long-term goals at Affinity? *
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