Nurse Practitioner
Employee’s Name
Evaluator’s Name
Evaluator’s Title
Date:
Objective: The objective of this evaluation is to assess the skills and care of the Nurse Practitioner’s performance after a 90-day observation. It is done as a method to assist, expand, and advance her or his skill set, and to ensure a standard of appropriate and acceptable performance within the office. This evaluation must be discussed with the employee within 15 days of the performance evaluation.
Evaluate the level of achievement for each area of performance exhibited during the past 90 days.
AREAS OF PERFORMANCE LEVEL OF ACHIEVEMENT
Culpability and Autonomy 5 - Outstanding