Agent Performance Evaluation Form

Quarterly Agent Assessment
Please select the individual you are providing feedback on

1. Overall how would you rate this individual's performance based on your expectations for the role?

	Significantly Below Expectations	Below Expectations	Meets Expectations	Above Expectations	Significantly Above Expectations
Functional Expertise Area and system expertise
Execution Pursues all assignments and projects until completion. Follows through on assignments to ensure successful completion.
Courage Confronts problems directly, taking action and being decisive. Does what is right for the patient.
Customer Focus Identifies customer needs and executes to meet or exceed customer expectations
Communication Communicates effectively one-on-one and in groups, while openly sharing knowledge and expertise
Adaptability Responds resourcefully, flexibly, and positively when faced with new challenges and demands. Moves forward productively and optimistically under conditions of change or uncertainty.
Influence Gains support for proposed changes through careful consideration of customer needs and interests
Engagement Commits to the mission, vision and objectives of the organization. Creates a sense of energy by empowering others and recognizing performance.
Relationship Building Contributes to a culture of respect, diversity and inclusion while maintaining strong relationships internally and externally
Strategic Thinking Demonstrates understanding of mission, vision, and strategies for business unit, function or region. Maintains the overall big picture of the business and its interrelationships.
Global Perspective Leverages solutions from all business functions

2. Please indicate the competency in which this individual most excels at, and provide explanation as to why (specific examples are desired).
3. Please indicate the competency in which this individual should focus on to drive the biggest impact to the organization, and provide explanation as to why (specific examples are desired).
4. What has this individual accomplished this year that has had the biggest impact on you?
5. In what way(s) does this individual contribute to overall team objectives and goals?
Please include your name (this will be removed when providing the feedback)
Should be Empty:

Quarterly Agent Assessment