2010 DFMC Employee Self Evaluation

EMPLOYEES * 🛈

JOB DESCRIPTION

*

DATE OF HIRE *

General Skills - RATE YOURSELF AGAINST YOUR PEERS

General Skills (1 = poor, 3 = average, 5 = excellent) *

	1	2	3	4	5
Possesses required skills for job	1	2	3	4	5
Understands job requirements per policy and procedure manual	1	2	3	4	5
Keeps job skills current	1	2	3	4	5
Organizes work to achieve goals	1	2	3	4	5
Identifies and solves problems	1	2	3	4	5
Achieves targeted results/goals of specific job	1	2	3	4	5
Communication skills,listens carefully and responds appropriately	1	2	3	4	5
Delivers friendly, courteous service to patients	1	2	3	4	5
Looks for and makes continuous improvements	1	2	3	4	5
Performs with accuracy, thoroughness and effectiveness	1	2	3	4	5
Seeks new challenges and increased responsibility	1	2	3	4	5
Self Sufficient works through challenges	1	2	3	4	5
Participates in learning and development activities	1	2	3	4	5
Accepts responsibility for own actions	1	2	3	4	5
Attends work as scheduled	1	2	3	4	5

Group Skills - RATE YOURSELF WITHIN THE TEAM YOU WORK WITH

Group Skills (1 = poor, 3 = average, 5 = excellent) *

	1	2	3	4	5
Is an effective team player	1	2	3	4	5
Works well with others	1	2	3	4	5
Runs with scissors	1	2	3	4	5
Willing to enlist others to help solve problems	1	2	3	4	5
Maintains respectful and cooperative working relationships	1	2	3	4	5
Demonstrates respect for individuals in all forms of communication	1	2	3	4	5
Offers assistance/support/encouragement to others	1	2	3	4	5
Willing to share knowledge of technology with team members	1	2	3	4	5
Handles interpersonal conflicts contructively	1	2	3	4	5
Accomplishes a fair and agreed-upon workload	1	2	3	4	5
Participates in group discussions/learning activities	1	2	3	4	5
Displays a positive attitude	1	2	3	4	5
Positively motivates others	1	2	3	4	5
Constructively uses feedback from peers	1	2	3	4	5
Demonstrates a willingness to compromise on team projects	1	2	3	4	5
Is able, in a respectful manner, to hold team members accountable for honoring their work commitments	1	2	3	4	5
Shares work responsibilities with a positive attitude	1	2	3	4	5

Overall, how do you rate YOUR performance as an employee of DFMC *

Feedback...

What is a specific strength you possess as an employee...in what way is that characteristic valuable to your peers? *

List one of your weaknesses as an employee and provide a suggestion to management on how they can assist you in overcoming that weakness. *

After you complete this form make a copy for yourself and click "Submit". The goal of this form is to provide information from which the employee and the administration, working together, can achieve a compelling and powerful work environment for the entire clinic.

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