Assessment Report

Assessment Report
Name of AIC or Lead Assessor*

First NameLast Name
Email*
example@example.com
Date of Assessment*

DayMonthYear
Date
Award(s) Assessed*

Bronze MedallionSRCARTIRB CrewSilver Medallion IRB DriverGold Medallion
Was this a Dry or Wet Assessment?

DryWetFull
Where was the assessment held?*
Number of Candidates that Presented*
Number of Candidates found Competent*
Were there any "reasonable adjustments" made? Please indicate what and why.
(eg. increased time for run-swim-run)
Did you or the assessment team identify any training issues at assessment?
Please include as many details as possible. ie. the assessment task, the issue and the Club.
Did you or the assessment team identify any issues with the assessment process, equipment, Delivery & Assessment Guide, or Central Venue Guidelines?
Please provide enough detail so the issue can be resolved.
Do you have any other comments we should consider?
Please upload copies of the assessment sign-in and/or attendance sheets here. Copies of Assessment Feedback forms (for NYC candidates) can also be uploaded.

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