Medical Assistant Evaluation Form
Please fill out this form to evaluate the performance of the medical assistant.
Evaluator's Name
First Name
Last Name
Evaluator's Position
Date of Evaluation
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Medical Assistant's Name
First Name
Last Name
Overall Performance Rating (1-5)
1
2
3
4
5
Communication Skills
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Technical Skills
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Patient Interaction
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Punctuality and Attendance
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Areas of Strength
Areas for Improvement
Additional Comments
Submit
Should be Empty: