425 Dental
Self Evaluation and Performance Prep
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Name
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First
Last
Position
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Personal (non-work) E-Mail
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To receive a copy of this form entry
Scale Questions 1 (low score/not meeting expectations) - 10 (highest score/exceeding expectations)
A rating of 1 to 6 equates to below expectations, a 7 or 8 equates to meeting expectations, and a 9 or 10 equates to exceeding expectations.
1. How would you rate yourself in performing your current role? Explain and give examples.
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1
2
3
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5
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7
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9
10
1) Explain and give examples.
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2. How would others in the practice rate your interactions with the others in the team? Explain and give examples.
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3
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6
7
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9
10
2) Explain and give examples.
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3. Rate your attendance over the last 6 months, and explain your rating.
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7
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9
10
3) Explain and give examples.
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4. Rate how your behaviors align with 425 Dental’s Core Values. Provide examples of areas of success and growth.
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1
2
3
4
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6
7
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9
10
4) Explain and give examples.
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5. What outside hobbies/interests are you excited in pursuing?
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6. What does your future at 425 look like in your eyes?
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7. Where are you being challenged the most at 425?
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8. Where are you excelling the most at 425?
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9. What have you done since the last meeting to grow and exceed in your current position?
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10. What do you feel like we are doing right?
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11. What do you feel we are doing wrong?
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12. What do you feel like we should be doing that we aren’t doing right now?
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13. Do you understand all the benefits and how to utilize them?
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14. Is there anything else you’d like for us to know?
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