Medical Scribe Performance Evaluation Form
Please complete this form to provide a structured evaluation of a medical scribe’s performance.
Evaluator Name
*
First Name
Last Name
Evaluator Role/Title
*
Scribe Name
*
First Name
Last Name
Date of Evaluation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Evaluation Period (e.g., Q1 2026, January 2026)
Please rate the scribe’s performance in the following areas:
*
Rows
Excellent
Good
Fair
Needs Improvement
Accuracy of Documentation
1
2
3
4
Timeliness of Chart Completion
5
6
7
8
Understanding of Medical Terminology
9
10
11
12
EHR System Proficiency
13
14
15
16
Professionalism and Conduct
17
18
19
20
Communication with Providers
21
22
23
24
Confidentiality and HIPAA Compliance
25
26
27
28
Overall Performance Rating
*
1
2
3
4
5
Strengths Observed
Areas for Improvement
Additional Comments or Recommendations
Would you recommend this scribe for continued assignment?
*
Yes
No
With Reservations
Submit Evaluation
Should be Empty: