ABSSD Letters of Recommendation Form

ABSSD Recommendation Form

American Board of Swallowing and Swallowing Disorders
Dear Recommendar, Please complete the following form AND attach a narrative letter of recommendation to this form. Note: Letters need to be on letterhead and signed. Thank you.
Applicants Name*
Recommender's Name*
Institution*
Address*
City*
State*
Postal Code*
Daytime Phone*
Email*
example@example.com
How long have you known this applicant?
Years/Months
In what capacity?
Approximately how many individuals have you known in a similar capacity?
Over how many years?
How would you rank this individual compared with other individuals you have had contact with in a similar capacity?
Percentage from 0 - 100%

	Superior (Top 5%)	Excellent	Good	Fair	Poor (bottom 25%)	Not Observed
Demonstrates Leadership
Practices with patient-centered clinical methods
Manages dysphagia cases effectively
Communicates effectively with peers, superiors and mentees
Communicates effectively with non-SLP personnel
Is independent in developing/implementing dysphagia protocols
Is a good collaborator
Displays good mentoring skills
What is your overall estimate of the applicant as a"Dysphagia Specialist"?

ABSSD Recommendation Form