Work Ethic Review Form
Team Member's Name
Date
-
Month
-
Day
Year
Date
Manager Email (so you receive a copy)
example@example.com
Dept Exec Email (so they can review)
example@example.com
Grading Scale Explanations
Mission Minded: Patient interactions are consistently cheerful, relational, and in line with our mission of providing the highest quality of care. This includes smiling, being warm and welcoming to patients, being eager to help them, and understanding to their needs above our own, even with the most challenging patients.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Communication: The ability to efficiently, accurately, and appropriately communicate info to patients, peers, and leaders. This includes being on top of emails, providing follow up when needed, and sharing your thoughts kindly and professionally.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Positive Attitude: The ability to remain kind and upbeat throughout your work day, even when there are challenges. Encourages and supports others and contributes positivity to the company's morale and culture on a regular basis. Shows empathy and compassion when appropriate, and doesn't engage in gossip or negative behaviors.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Dependability: PVC can trust that you will be on time, ready to work each day that you are scheduled. You can be trusted to complete assigned tasks because you have shown that you can be counted on.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Teamwork: The ability to work well with your coworkers, building positive professional relationships, and helping without being asked. This also includes demonstrating respect towards leaders and following instruction as a team member.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Adaptability: The ability to be flexible and adapt to change without complaint or a poor attitude. This also includes being willing to learn, be resourceful in different situations, and adjusting how you communication in different situations.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Initiative: Completing tasks without being asked or reminded. You take advantage of optional opportunities, find out what you need with the resources available, and are engaged in your work.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Productivity: you complete your work efficiently, managing your time wisely, and complete your work accurately and effectively. You stay on top of your tasks and work hard to achieve goals.
Unacceptable
1
2
3
4
Outstanding
5
1 is Unacceptable, 5 is Outstanding
Comments:
Total Score:
(adding all of the ratings together, max score is 40)
Total Hub points Awarded:
(adding all of the ratings together, max score is 40)
Additional Comments:
Include any specific work ethic goals that can be worked on this year!
Submit
Click here when meeting with your team member so they can sign off on this review! :)
Team Member Signature
Manager Signature
Should be Empty: