POPULAR PHARMACY PERFORMANCE EVALUATION 2020
Did you get the WHY?
1
2
3
4
5
Why there is a Popular Pharmacy according to you?
*
Name
*
First Name
Last Name
Email
example@example.com
Date
*
-
Year
-
Month
Day
Date
WHAT IS YOUR JOB TITLE
*
Pharmacist
Pharmacy Technician
Delivery Driver
Cashier
Pharmacy Operations Manager
Pharmacy Manager (PIC)
How many years of service?
*
CURRENT RESPONSIBILITIES
*
GENERAL PERFORMANCE
*
ACCOMPLISHMENTS
*
AREAS FOR IMPROVEMENT
*
PROGRESS TOWARDS GOALS
*
SMART GOALS
*
PROFESSIONAL DEVELOPMENT
*
QUALITY OF WORK
Work is of the highest quality and free from error.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Work is comprehensive in scope and complete in detail.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Readily isolates and solves problems.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Contributes sound new ideas which will improve methods or increase profits.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Follows policy and procedures.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Obtains needed information from patient at time of filling/selling to register new patient or verify existing patient at drop off, drive thru and pick up
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Perceives problems with completion of filling process, alerts pharmacist and moves to resolve problem with a problem solving mentality.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Correctly reads prescription, interprets physician intent, and processes prescription in a precise, efficient manner.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Capable of manual filling and pricing of prescriptions in the event of computer downtime.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Works with pharmacist towards completion of prescription filling procedure.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Exhibits ability to adjust to work load, appropriately finding secondary projects when primary work lessens.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Exhibits ability to adjust to work load, appropriately finding secondary projects when primary work lessens ( down time )
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Presents prescription and supporting items to pharmacist in an ordered, logical manner for final check prior to dispensing.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Capable of executing other duties assigned by pharmacist to assist in the smooth, efficient operation of the store.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Reorders product used if necessary or makes notation of need to reorder at a later time on own initiative.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Understands and performs order check-in/return/reorder process without need for supervision or follow-up
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Displays capability of compiling and sending completed orders at pre-arranged times without supervision.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Works with pharmacist to establish and maintain inventory at acceptable levels.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Cooperates with management and other employees in promoting the front store’s attractiveness, cleanliness, efficiency and superior customer service levels.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Preventive maintenance on workstations, POS, and other equipments in pharmacy is done properly and in a timely manner.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Demonstrates a working knowledge of medications and documentation procedures.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Able to evaluate situations and make sound judgments. Defers to pharmacist those matters that should be handled directly by same.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Able to perform job with little or no supervision.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Attempts to expand knowledge base to handle challenges better through identifying learning needs, setting goals and seeking opportunities for personal and professional growth.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
PROFESSIONAL BEVAVIOR
Dependable-on the job when scheduled and ensures manager is properly notified when absent or tardy.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Does not use time for non business purposes. Holds self accountable to work as scheduled and observes store policies with regard to lunch and break time.Holds self accountable on mobile phone use/ personal calls to and from pharmacy.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Shows kindness and consideration to fellow employees and customers.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Demonstrates respect and high levels of cooperation with supervisor.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Dresses appropriately for the job and be ready to work as soon as clocked in.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Ensures grooming and pharmacy complies with safety operating policies and standards. ( no chair / no food / no gossip )
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Ensures all equipment and tools are used in a safe manner..
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Uses equipment and facility effectively and economically. Uses electricity conservatively by switching off lights in rooms/restrooms when not in use. throw away soiled napkins appropriately
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Keeps work area neat and clean. Organize and file all prescriptions by end of shift, leave notes to follow up
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Safeguard Professional pharmacist/patient confidentiality
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Handles patient complaints in a caring and efficient manner, and report immediately to pharmacy manager.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Accurately handles transactions of cash at time of sale.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Capable of handling charge card sales/returns without supervision
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Follows cash control procedures and maintains accurate checks on money.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Exhibit sound understanding of third party billing and reconciliation, and a capability of executing same without supervision or follow up.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Capable of completing necessary reports for daily and weekly accounting purposes.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Communicates ideas and results of work effectively both orally and in writing.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Able to bill medicare part B, able to determine eligibility, and prescription requirements.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Demonstrates a working knowledge of medical equipment and documentation procedures. Sends out proper paperwork to ensure Medicaid/Medicare reimbursements on supplies and/or equipment and chooses appropriate method (phone, fax or mail). Able to handle issues with EBS
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Understands and performs order check-in/return/reorder process without need for supervision or follow-up
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Tends to be helpful and productive beyond assigned duties.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Economizes on supplies. Does not waste materials.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Able to evaluate situations and make sound judgments.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Overall attitude is positive. Provides prompt, friendly service to the patient in person, by fax, and by telephone.
1
2
3
4
5
Relative comments on the ratings of last questions with examples of success or failure .
*
Is persistent in carrying out job duties, regardless of what unusual circumstances may occur
This matrix type is not available for legacy form layout.
Knows job procedures and is skillful in performance of assigned job duties.
This matrix type is not available for legacy form layout.
Should be Empty: