University of Mississippi Medical Center Employee Performance Review Form. Employee Position Title: Employee Job Code: Employee Grade:

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1 University of Mississippi Medical Center Employee Performance Review Form Employee Name: Employee Number: Employee Position Title: Employee Job Code: Employee Grade: Department Name: Today s : Supervisor Name: Supervisor Title: Supervisor Employee Number: Evaluator Name: (If different from Supervisor) Evaluator Title: (If different from Supervisor) Evaluator Employee Number: (If different from Supervisor) Employee FLSA Status: Exempt Non-exempt Instructions: For each of the traits listed below, check the rating that best represents the employee s performance. 1. QUALITY Consider neatness and accuracy of work regardless of volume. SUPERIOR Exceptionally accurate. Quality greatly exceeds department s requirement. GOOD - Few errors. Quality consistently exceeds department s requirement. SATISFACTORY - Does acceptable work. Meets department s requirements. FAIR - Quality is inconsistent and minimally acceptable at best. UNSATISFACTORY - Frequent errors. Quality is unacceptable.

2 2. QUANTITY Consider the volume of work produced. SUPERIOR - Volume greatly exceeds department s requirement. GOOD Volume consistently exceeds that which the department considers to be satisfactory. SATISFACTORY Productivity meets the department s requirement. FAIR Productivity is below that which the department considers to be satisfactory. Department s goal or standard is rarely met. UNSATISFACTORY Consistently low volume. Productivity is far below the department s requirement. 3. KNOWLEDGE Consider how well employee knows and understands procedures and other related functions essential to good performance. SUPERIOR - Considered an expert in the department. Has mastered all phases of his/her job and knows how it relates to other jobs within the department. GOOD - Well informed. Has thorough understanding of the job and its relationship to other jobs. SATISFACTORY Understands the essential elements of his/her own job. FAIR Does not fully comprehend what his/her job entails. Needs additional training in some areas. UNSATISFACTORY Knowledge is deficient. Needs additional training in several areas.

3 4. ATTITUDE Consider the amount of interest and enthusiasm toward the work, the institution and its policies and procedures. SUPERIOR - Extremely optimistic and enthusiastic. Very supportive of institutional policies/procedures. GOOD - Maintains a positive attitude. Continuously strives to improve. Above average display of support for institutional policies/procedures. SATISFACTORY Adequate interest shown. FAIR Limited interest. Frequently complains about the work. UNSATISFACTORY - Pessimistic; Always critical of work assignments/institutional policies. 5. DEPENDABILITY - Consider the extent to which employee can be counted on to carry out instructions; degree of supervision needed. SUPERIOR - Exceptionally dependable. Requires little, if any supervision. GOOD - Consistently dependable on routine assignments. Occasionally requires minimal supervision in non-routine matters. SATISFACTORY - Can be counted on to adequately handle routine work but needs continuous supervision when assigned to special projects. FAIR - Needs frequent supervision regardless of the task. Cannot always be depended upon. UNSATISFACTORY - Completely unreliable. Requires close, continuous supervision.

4 6. COOPERATION - Consider how well employee works in harmony with supervisors and co-workers. SUPERIOR - Very cooperative. Maintains good relationships with everyone. GOOD - Puts forth extra effort to get along with co-workers and supervisors. SATISFACTORY - Maintains acceptable relationships. Rarely has conflicts. FAIR - Occasionally causes friction within the department. At time has difficulty dealing with others. UNSATISFACTORY - Resists supervision. Frequently causes antagonism and unrest among others. 7. ADAPTABILITY - Consider employee s flexibility. Can he/she adapt to a variety of situations? SUPERIOR - Very flexible. Can adjust to any situation without a problem. GOOD - Able to adapt to most situations. SATISFACTORY - Sufficiently flexible to meet the demands of the department. FAIR - Has difficulty accepting changes. UNSATISFACTORY - Unable to adjust to different assignments or situations.

5 8. INITIATIVE - Consider whether or not the employee works independently; is a self starter; knows what needs to be accomplished. SUPERIOR - Completely independent. Always knows what needs to be done. GOOD - Works independently in most situations. Usually knows what to do next. SATISFACTORY - Works independently in routine situations be needs guidance and direction in non-routine matters. FAIR - Rarely a self starter. Frequently has to be told what to do. UNSATISFACTORY - Incapable of working independently. 9. ATTENDANCE AND PUNCTUALITY - Consider whether or not employee is present when scheduled to work and on time. SUPERIOR - Attendance and punctuality records are nearly perfect. GOOD Seldom absent or tardy. SATISFACTORY Attendance and punctuality adequate. FAIR - Some difficulty in attendance/punctuality. UNSATISFACTORY - Frequently absent or late without notice.

6 Summary Based on the individual ratings given, what overall rating would you assign this employee? 1 SUPERIOR 2 3 GOOD 4 5 SATISFACTORY 6 FAIR 7 UNSATISFACTORY Describe those areas in which the employee s performance is best. What can this employee do to improve performance?

7 Employee Remarks: (Areas in which you believe you do well; recognized areas for improvement; suggestion and criticism) Signatures: Employee s Signature and Employee Number (Signature indicates that performance review has been reviewed and discussed with employee.) Supervisor s Signature and Employee Number Evaluator s Signature and Employee Number (Complete if Evaluator is different from Supervisor) Department Head s Signature and Employee Number

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