Agent Performance Evaluation Form
Name of the individual you are providing feedback on
First Name
Last Name
1. Overall how would you rate this individual's performance based on your expectations for the role?
Rows
Significantly Below Expectations
Below Expectations
Meets Expectations
Above Expectations
Significantly AboveExpectations
Functional Expertise Area and system expertise
1
2
3
4
5
Execution Pursues all assignments and projects until completion. Follows through on assignments to ensure successful completion.Â
6
7
8
9
10
CourageConfronts problems directly, taking action and being decisive. Does what is right for the patient.
11
12
13
14
15
Customer Focus Identifies customer needs and executes to meet or exceed customer expectations
16
17
18
19
20
Communication Communicates effectively one-on-one and in groups, while openly sharing knowledge and expertise
21
22
23
24
25
AdaptabilityResponds resourcefully, flexibly, and positively when faced with new challenges and demands. Moves forward productively and optimistically under conditions of change or uncertainty.
26
27
28
29
30
Influence Gains support for proposed changes through careful consideration of customer needs and interests
31
32
33
34
35
Engagement Commits to the mission, vision and objectives of the organization. Creates a sense of energy by empowering others and recognizing performance.
36
37
38
39
40
Relationship BuildingContributes to a culture of respect, diversity and inclusion while maintaining strong relationships internally and externally
41
42
43
44
45
Strategic ThinkingDemonstrates understanding of mission, vision, and strategies for business unit, function or region. Maintains the overall big picture of the business and its interrelationships.
46
47
48
49
50
Global PerspectiveLeverages solutions from all business functions
51
52
53
54
55
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)
First Name
Last Name
Submit
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