Annual CAPS Personnel Feedback Form

Annual CAPS Personnel Feedback
By sharing your experiences, insights, and suggestions, you contribute to improving the areas where we can grow and help shape the future of CAPS. Your input is invaluable in creating a more fulfilling and impactful experience for everyone involved. Please answer as many of the questions as you feel comfortable with.

Your feedback will be shared with your supervisor and discussed with you during your Annual Appraisal.

Thank you for your commitment to serving with CAPS and supporting women and couples facing unintended pregnancies with medical services, education, and resources in a caring and confidential environment.
Name*

First NameLast Name
Email*
example@example.com
Area of Service*

MedicalNon-Medical
Role*

VolunteerEmployee
Name of Supervisor*
Name of Supervisor*
Looking back on this past year, what aspects of your role were most meaningful to you?
What do you see as the biggest need of patients which is not currently being met? Do you have any suggestions for meeting this need?
Are there any areas, projects, or tasks where you believe improvements could be made? If so, what suggestions would you offer?
How could we improve Inservices / Medical Team Meetings? Any particular topics you would like to learn more about?
What new skills or roles, if any, would you be interested in exploring or developing in the future?
On a scale from 1-10 how much do you enjoy serving at CAPS?

1

2

3

4

5

6

7

8

9

10

1 is Not at all, 10 is Completely
What could make this # higher?
Do you feel you receive adequate supervision/guidance as you work at CAPS? If not, please explain.
What is your biggest need as a team member that is not being met?
How are you feeling about your relationship with other employees/volunteers? Any concerns?
Please talk to the Executive Director in person if you don’t feel comfortable writing anything down
As we look ahead to next year, do you foresee your level of involvement increasing, decreasing, or staying the same?
What are your goals for the coming year as a team member?
If you are an employee please come up with at least 2 goals.
Should be Empty: