Nursing Annual Performance Evaluation Questionnaire
Please complete this form to evaluate nursing performance over the past year. Both self-assessment and supervisor review sections are included.
Nurse's Full Name
*
First Name
Last Name
Position/Title
*
Department/Unit
*
Evaluation Period (e.g., Jan 2025 - Dec 2025)
*
Self-Assessment: Please rate your performance in the following areas.
*
Rows
Needs Improvement
Meets Expectations
Exceeds Expectations
Clinical Knowledge and Skills
1
2
3
Patient Care and Safety
4
5
6
Communication with Patients and Families
7
8
9
Teamwork and Collaboration
10
11
12
Professionalism and Ethics
13
14
15
What are your key accomplishments this year?
*
Supervisor Assessment: Please rate the nurse's performance in the following areas.
*
Rows
Needs Improvement
Meets Expectations
Exceeds Expectations
Clinical Knowledge and Skills
16
17
18
Patient Care and Safety
19
20
21
Communication with Patients and Families
22
23
24
Teamwork and Collaboration
25
26
27
Professionalism and Ethics
28
29
30
Overall Performance Rating
*
1
2
3
4
5
Areas for Improvement (Supervisor's Comments)
Goals and Professional Development Plans for Next Year
*
Additional Comments (Optional)
Submit Evaluation
Should be Empty: