Working Interview Evaluation Form – Non‑Selected Candidates

Working Interview Evaluation Form | Non‑Selected Candidates

This form is used to document feedback from the working interview for candidates who were not selected for hire. The information collected supports fair and objective hiring decisions and helps identify skill gaps, training needs, or experience areas required for success in the role. For candidates you wish to move forward with an offer, please complete the Working Interview Feedback section within the Request for Offer JotForm instead
Name of candidate*

First NameLast Name
Date of Interview*

MonthDayYear
Date
Role interviewing for*
"Other" job title:
Name of manager completing form*
Regional Manager*
Please describe candidate's alignment to Riccobene/Commonwealth Core Values*
Please rate candidate's clinical skillset (if interviewing for clinical position)
Please describe candidate's clinical skillset *
Please rate candidate's nonclinical skillset
Please elaborate on nonclinical skills (ex. scheduling, phone demeanor) *
I confirm I have received doctor(s) feedback on this candidate*
Feedback from doctor on this candidate:*
What additional training or skills would this candidate need to be a stronger fit for this role?*
Would this candidate be a better fit for another position or location? If yes, please elaborate in " Other Comments"
Other comments
Should be Empty:

Working Interview Evaluation Form | Non‑Selected Candidates