Performance Review — Self Assessment

Objective

The objective of the Wellbeing Chiropractic Staff Performance Review is to facilitate a formal and mutually agreed upon system of planning and reviewing performance.

2-way Feedback: Reinforces strengths, or provides opportunities to discuss areas for development.

Career Development: Opportunity to discuss career objectives and create a strategy to maximise potential in your role.

Organisational Goals: Opportunity to view performance in line with organisational objectives.

Position Expectations: Opportunity for clearer definition of performance expectations in your role.

Instructions

Please complete Parts A, B and C and submit this form one week prior to your appraisal interview. Part D will be completed together at your meeting.

Part A – Your details

Part B – Self-evaluation & rating

Part C – Discussion points

Part D – Action plan (completed at meeting)

Part A — Your Details

Full name *

Clinic/s

Position

Reports to

Appraisal interview date / time

Appraisal period

Part B — Self Evaluation

Significant area for development – not performing at required level

Competent – meeting required level

Significant strength – exceeds expectations

Outcome 1: Measurable results and outcomes

Contributes to the achievement of team goals and individual role objectives. Patient information management including treatment notes.

Compliance ratesRebook rates Weekly patient numbersDNA PVACXLPre-pay %

Your self rating

Significant area for development Competent Significant strength

Areas for improvement

Outcome 2: Contribution to team & continuous improvement

Displays accountable behaviours as part of an effective and positive workplace culture. Positive and solution-based approach to improvement areas.

TeamExcellence GrowthEducation

Your self rating

Significant area for development Competent Significant strength

Areas for improvement

Part C — Discussion Points

Please answer the following with examples where relevant. Complete prior to your appraisal meeting.

1. What are your most important priorities and responsibilities in your current role?

2. Has the past year been mainly positive or otherwise for you? Please list reasons why.

3. What do you like and dislike about working for this organisation?

4. What elements of your job do you find most difficult or frustrating?

5. What actions can you undertake to improve your performance in your current position?

6. What actions could be taken to improve your performance by your manager?

7. What sort of training and/or experiences would benefit you in the next year?

8. Do you have any suggestions to improve our team's performance and quality of service?

Thank you for completing your self assessment.

Please submit this form one week before your appraisal. Part D — Action Plan will be completed together at your meeting.

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Outcome 1: Measurable results and outcomes

Outcome 2: Contribution to team & continuous improvement

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