Working Interview Feedback Form

Working Interview Feedback Form
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:*
Would you recommend this candidate for hire?*

YesNo
If yes, what training would this candidate benefit from?*
If no, please explain*
Would this candidate be a better fit for another position or location? If yes, please elaborate in " Other Comments"
Other comments
Should be Empty: