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Sample Counselor Performance Evaluation

Sample Direct Services Competency Performance and Appraisal Plan Psychotherapist/Case Manager Location: _____ Name: Date: Date Employed: Title: Name/Position of Evaluator: Appraisal Period: From To Annual Performance Appraisal Initial Probationary Performance Appraisal Special Performance Appraisal (specify reason): Other (specify reason): Content Areas Section A: Major Areas of Responsibility Section B: Skills and Ability Section C: Documentation of Achievement Section D: Documentation of Areas of Needed Development Section E: Overall Performance Rating Section F: Board /Evaluators Comments Section G: Goals/Objectives for Upcoming Appraisal Period Section H: Recommendations for Corrective Plan Score Major Areas of Responsibility Skills and Abilities Objective The Purpose of a Performance appraisal is to objectively evaluate an employee s professional Performance in accordance with the position description.

SAMPLE Direct Services Competency Performance and Appraisal Plan Psychotherapist/Case Manager MAR 6: Provide psychotherapy and case management services as indicated within the accepted standards. (6) GOES BEYOND MOST JOB REQUIREMENTS IN THIS AREA: Considered an expert. (5) GOES BEYOND SOME JOB REQUIREMENTS IN THIS AREA: …

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