Performance Evaluation Form for Licensed Healthcare Professionals
This form is designed for evaluating licensed healthcare professionals. It provides comprehensive instructions and fields for references to assess candidates. Use this form to ensure that all candidate evaluations are recorded accurately.
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How do I fill this out?
To fill out this form, begin by entering your contact information in the designated fields. Next, provide details regarding the candidate’s work performance and clinical skills based on your observation. Finally, ensure all sections are completed and submit the form as per the provided instructions.

How to fill out the Performance Evaluation Form for Licensed Healthcare Professionals?
1
Enter your contact information and details about the candidate.
2
Assess the candidate's performance by selecting the appropriate ratings.
3
List any strengths of the candidate that would support their application.
4
Review all entered information for accuracy and completeness.
5
Submit the completed form via the specified channel.
Who needs the Performance Evaluation Form for Licensed Healthcare Professionals?
1
Healthcare facilities requiring candidate evaluations for employment.
2
Nursing supervisors assessing the performance of their staff.
3
Recruiters needing references for candidates in the healthcare sector.
4
Educational institutions verifying practical experience of nursing students.
5
HR departments needing standardized performance evaluations.
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How do I edit the Performance Evaluation Form for Licensed Healthcare Professionals online?
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What are the instructions for submitting this form?
Upon completing the performance evaluation form, it must be submitted either electronically via the provided email, or returned through fax at (858) 939-1828. Ensure that all fields are filled accurately to facilitate effective review. It’s advised to retain a copy of the submitted form for your records.
What are the important dates for this form in 2024 and 2025?
The performance evaluations align with the annual review schedule, which occurs in March each year. Ensure all evaluations for potential hires are submitted by the end of February. For 2025, be prepared for similar timelines.

What is the purpose of this form?
The purpose of this performance evaluation form is to standardize how references assess the capabilities of healthcare professionals. It ensures that potential employers receive consistent and thorough evaluations of candidates. Employing this form can streamline the hiring process and enhance communication between supervisors and HR departments.

Tell me about this form and its components and fields line-by-line.

- 1. Candidate Name: The name of the candidate being evaluated.
- 2. Facility Name: The name of the healthcare facility where the candidate worked.
- 3. Evaluator Name: The name of the person completing the evaluation.
- 4. Overall Professionalism: An assessment of the candidate's professionalism in the workplace.
- 5. Comments: Additional comments regarding the candidate’s strengths and areas for improvement.
What happens if I fail to submit this form?
Failing to submit this form may result in delays in the candidate’s evaluation process. It's important to ensure that submissions are timely to facilitate hiring decisions.
- Delayed Hiring Process: Incomplete or late submissions can cause delays in hiring decisions.
- Inaccurate Assessments: Missing information can lead to misunderstandings about a candidate’s abilities.
- Professional Relationships: Failure to comply may affect relationships with candidates and employers.
How do I know when to use this form?

- 1. Hiring Process: Utilize this form for candidates being considered for employment.
- 2. Employee Evaluations: Use during annual reviews to assess employee performance.
- 3. Reference Checks: Required for verifying candidate qualifications before hiring.
Frequently Asked Questions
How can I fill out this performance evaluation form?
Start by entering your personal and candidate information. Follow the instructions for assessing the candidate's abilities and provide feedback as required.
What should I do if I miss a field?
It's important to review the form before submission to ensure all fields are completed.
Can I edit the form after downloading?
Yes, you can re-upload the downloaded form to PrintFriendly for further edits if necessary.
How do I submit the filled form?
Submit your filled form via fax or the designated email provided.
Is there a way to ensure my information is secure?
Use secure practices when handling forms and only share them through trusted communication channels.
Can I share this form with colleagues?
Absolutely, once you have downloaded the document, you can easily share it.
Is there a mobile option available for filling out this form?
Yes, PrintFriendly is accessible via mobile devices for convenience.
What happens if I submit an incomplete form?
Submitting an incomplete form may delay the evaluation process.
Are there instructions for filling out the sections?
Yes, detailed instructions are provided within the form.
Can I reprint or save the filled form?
Yes, after completion, you have the option to print or save the filled form.
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