Field Training Officer Evaluation
Please use the form below to accurately evaluate your experience with the FTO during your training shift. This information is sent ONLY to the Clinical Division. Please feel free and open to rate and describe your experience.
FTO Name
*
Please Select
Aida Garcia
Gregory Scarborough
Stephanie Olaya
Valerie Rosalessorto
Matt Tomlinson
Other - Not Listed
FTO Name
*
Did you receive your DOR for this shift?
*
Yes
No
Pending and will follow up with my FTO
The Field Training Officer: (Use N/A only when Necessary)
*
Strongly Agree
Agree
Disagree
Strongly Disagree
N/A
Communicated Objectives
and expectations at start of shift
Demonstrated an
efficient knowledge of Policies
and Procedures
Demonstrated an
efficient knowledge of Protocols
and Guidelines
Was
motivated to assist me
outside of running a call
Set an example
of proper behavior and job performance
Allowed me to
utilize skills
and
manage the scene
Intervened only when necessary
Demonstrated teamwork
and diplomacy
Effectively communicated
evaluation of my performance
Provided feedback and
offered suggestions
for improvement
Feedback and
evaluation was accurate
and objective evaluations
Was able to
answer questions
or locate appropriate references
Demonstrated
integrity
and upstanding
customer service
with patients, partners, and medical staff
Demonstrated
effective time management
Completed evaluation
s in a timely manner
Had a good
overall attitude
Acted as a
positive role model
and steward of the corporate mission, vision, and values
Positive Experiences During Training Shift
*
Experiences During Training Shift That Could Improved
*
Do You Have Any Unmet Needs As A Trainee? (if Yes, please explain)
*
What is your goal(s) for your next shift?
*
Would you like follow-up regarding this evaluation?
*
Yes
No
Trainee Name: By typing my name below, I am attesting the information above is accurate and complete.
*
Yes
No
Trainee's email
*
Date
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit
Should be Empty: