Veterinary Team Member

Performance Review
Employee Name/Title:

Evaluator Name/Title:

Date:

Evaluation Type:

❏ Annual/6-Month Review
❏ New Employee
❏ Probationary
❏ Other

Instructions

This evaluation worksheet may be used to measure employee performance and/or as a development tool to
recognize achievement, help team members hone skills, set goals, and pinpoint problems. The evaluation has 3
components.

Part 1 | Employee Self-Review: Employee being reviewed should complete this first.

Part 2 | Evaluator Review: Evaluator should complete but only after reading and taking into consid-
eration the employee’s responses to Part 1.

Part 3 | Goals Worksheet and Completion Report: After Parts 1 & 2 have been completed, a per-
formance review should be scheduled. At this meeting, employee and evaluator should work together to
create goals and record them on the Goals Worksheet. At the end of the meeting, the employee and
evaluator should sign the Performance Review Acknowledgment indicating that the meeting was held.
Part 1 | Employee Self-Review
Employee Name/Title:

Evaluator Name/Title:

Instructions

Please list your top 6 responsibilities below and use the following scale to rate your performance for each.

1 Failure to meet requirements of present job

2 Substandard, sometimes achieves satisfactory results, obvious room for improvement

3 Satisfactory, performance is that of a well-trained employee in this job

4 Achievements exceeded what was expected of a well-trained employee in this job

5 Consistently demonstrated outstanding and exceptional achievements

Job Responsibilities My Rating

1. __________

2. __________

3. __________

4. __________

5. __________

6. __________
A. What contributions did you make to the practice this year?

B. What skills have you developed or improved on since your last review?

C. What responsibilities could be added to your job that would more fully utilize your strengths?

D. What do you want to improve on? What are some suggestions for how you might achieve this improvement?

E. Describe other job interests you have,

F. What skills/training/CE would you need to achieve the job interests you listed above?

G. List possible goals and objectives to be achieved by the next evaluation period.
Part 2 | Personnel Evaluation Form
Employee Name/Title:

Evaluator Name/Title:

Instructions
This form should be filled out by the evaluator. Circle the appropriate number; include comments as warranted.

DEPENDABILITY
1. Requires close supervision; is unreliable
2. Sometimes requires prompting
3. Usually takes care of necessary tasks; completes with reasonable promptness
4. Requires little supervision; is reliable
5. Requires absolute minimal supervision

Evaluator’s Comments:

ATTENDANCE
1. Often absent without good excuse and/or frequently reports to work late
2. Lax in attendance and/or reporting to work on time
3. Usually present and on time
4. Very prompt; regular in attendance
5. Always regular and prompt; volunteers for extra shifts when needed

Evaluator’s Comments:

PRODUCTIVITY & INITIATIVE

1. Unsatisfactory—puts forth no effort to achieve goals
2. Substandard—puts forth little effort to achieve goals
3. Satisfactory—puts forth effort to achieve goals
4. Above average—strives hard, high desire to achieve goals
5. Outstanding—sets high goals, strives incessantly to achieve these

Evaluator’s Comments:

COMMUNICATION
1. Exhibits unprofessional communication aptitude most of the time
2. Exhibits unprofessional communication aptitude some of the time
3. Exhibits satisfactory communication skills
4. Usually exhibits clear, precise, professional, and respectful communication
5. Always clear, precise, professional, and respectful communication

Evaluator’s Comments:
CREATIVITY & PROBLEM-SOLVING SKILLS
1. Rarely suggests new ideas or ways to solve problems
2. Occasionally has a new idea or solution
3. Offers an average amount of new ideas and solutions
4. Frequently suggests new ways of doing things; very imaginative
5. Continually seeks new and better ways of doing things; extremely imaginative

Evaluator’s Comments:

DECISION-MAKING ABILITY
1. Consistently makes inappropriate decisions
2. Not consistent; sometimes makes inappropriate decisions
3. Generally arrives at the appropriate decision
4. Usually arrives at the appropriate decision without delay
5. Almost always arrives at the appropriate decision with minimal delay

Evaluator’s Comments:

QUALITY OF WORK
1. Makes frequent errors
2. Careless; makes recurrent errors
3. Usually accurate; makes an average number of mistakes
4. Requires little supervision; is exact and precise most of the time
5. Requires absolute minimum supervision; is almost always accurate

Evaluator’s Comments:

STRESS MANAGEMENT
1. Appears to “go to pieces” or gets nervous under pressure
2. Appears irritated or occasionally “blows up” under pressure
3. Appears to have a normal tolerance for pressure; usually appears calm
4. Tolerates most pressure; likes crises more than the average person
5. Thrives under pressure; really likes solving crises

Evaluator’s Comments:

WORKING RELATIONSHIPS: ALL TEAM MEMBERS

1. Exhibits behavior that negatively affects team culture
2. Exhibits aloof, distant, or uncommunicative behavior
3. Agreeable and pleasant to team members
4. Polite and willing to help others; exhibits a “can do” attitude
5. Excellent at establishing good will; leads the team by example

Evaluator’s Comments:
CLIENT INTERACTION
1. Blunt or discourteous with clients
2. Introverted, distant, uncommunicative with clients
3. Satisfactory
4. Very professional, outgoing, polite
5. Outstanding customer service and excellent client communication

Evaluator’s Comments:

Overall Areas of Strength:

Overall Areas to Improve:

Evaluator: Tally the ratings (count how many number 1s, number 2s, etc) and circle the appropriate evaluation
number. The evaluation number is the number below that there are the most of. For instance, if you have: 8 of
(#4), 1 of (#5), 1 of (#3) you have a majority of #4s. You would then circle #4 below.

1. Failure to meet requirements of present job. Performance indicates deficiency that seriously interferes
with attainment of expected results.

2. Performance does not meet required standards. Sometimes achieves satisfactory results, but there is
obvious room for improvement.

3. Job performance is satisfactory.

4. Achievements contribute to practice goals and performance exceeds job requirements.

5. Job performance consistently and significantly exceeds position requirements. Exceptional achieve-
ment is demonstrated in key areas of responsibility.

Overall Evaluation Rating 1 | 2 | 3 | 4 | 5

Part 3 | Goal Setting & Performance Review Acknowledgment
Employee Name/Title:

Evaluator Name/Title:

Goal Setting Worksheet

List SMART goals and objectives this employee is expected to achieve during the next appraisal period. SMART goals
are Specific, Measurable, Achievable, Realistic, and Time based. For example: Learn to place and maintain an in-
dwelling catheter in the next 3 months; increase production [number] % by next quarter; improve history taking by
asking 3 open-ended questions; consistently ask clients to schedule next appointments during check-out.

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Performance Review Acknowledgment

A performance review meeting was held on ________________________________________________________________

between _________________________________________________________________________________ (employee) and

________________________________________________________________________________________________ (evaluator)

at which the performance of the employee was discussed.

___________________________________________________________
Employee Signature

___________________________________________________________
Evaluator Signature

___________________________________________________________
Practice Owner Signature

Date: