Therapist "Personality" Checklist

Therapist "Personality" Checklist

Evaluation Form
Name*

First NameMiddle NameLast Name
Date*

MonthDayYear
Date
Branch*
Corporation*
A. GENERAL KNOWLEDGE
1. Use & application of medicines*

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2. Performance of procedure*

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B. PHYSICAL APPEARANCE
3. In "Make-Up"*

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4. Hair in Pony Tail/ Half Pony*

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5. Clean Uniform and Shoes*

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6. In Mask while treating*

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C. CUSTOMER RELATIONS
7. Always "Smiling"*

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8. Greets "Patients"*

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9. Greets "Walk-in"*

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10. Can answer well to all "Inquiries"*

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11. Focuses on work/ treatment of the patients*

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12. Courteous & well mannered*

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D. SALE ABILITY
13. Can easily persuade & "Bring In" patients*

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14. Can easily sell medicines*

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E. CARE CLINIC
15. Cleans clinic premises*

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16. Does "After Care"*

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17. Cleans & Organized materials, Equipment, etc.*

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F. OFFICE ORDER
18. Does proper recording of treatment & sales*

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19. Entries in DOR, TSR & CLIMAX*

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20. Follow and Obey Company rules & Policies*

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G. PEER RELATION
21. Gets along well co-workers & other*

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22. Obey her superior & management*

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