Transcription of ANNUAL EVALUATION - PN System
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Example: dental hygienist
ANNUAL EVALUATION - PN System
EVALUATIONYear: _____Sample 1-855-PNSystemSample 1-855-PNSystemEMPLOYEE EVALUATION SHEET - PROBATION PERIOD / ANNUAL * (circle)Name of Employee: _____Date of Employment: _____ Position/Title: _____Immediate Supervisor: _____EVALUATIONITEM DiscussedExceptional SatisfactoryNon-SatisfactoryImprovement NeededPersonal appearance/ Code of conduct/ BehaviorPunctuality/Visits Frequency complianceAttitude to work /Attitude to other workers and staff Acknowledgment/ Contract-Agreement reviewedAttitude-Communication with patients/familyResponsibility, JOB DESCRIPTION Discussion in details,follow Physician Plan of Care, Updates as guidelinesInitiative/Duties/Abilities/QA -QI-PI/Agency Evaluationprogram participation/learning experienceMorals/Ethics/Courtesy/Conflic t of interestAbility to record relevant notes, delivery on time,documentation guidelines complianceAbility to communicate in legible, professional manner,participation in Case Conference, follow standardsprecautions, Infection control of professional procedures, , Participation in continue education, In-servicesprogram, Reporting guidelines (Agency.)
EMPLOYEE RESPONSE INPUT (Self Evaluation) (To improve our services to our patients we need your input and concern, please fil out the following form, and
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