Behavioral Health Fellowship Evaluation Form

Behavioral Health Fellowship Evaluation Form
Please assess the fellow’s performance and readiness across multiple professional domains.
Fellow’s Name
Evaluator’s Name
Professional Competence

1
2
3
4
5
1 is Needs Improvement, 5 is Outstanding
Clinical Knowledge and Skills

1
2
3
4
5
1 is Needs Improvement, 5 is Outstanding
Communication with Patients and Team

1
2
3
4
5
1 is Needs Improvement, 5 is Outstanding
Professionalism and Ethical Behavior

1
2
3
4
5
1 is Needs Improvement, 5 is Outstanding
Teamwork and Collaboration

1
2
3
4
5
1 is Needs Improvement, 5 is Outstanding
Growth Areas Assessment
Rows Strongly Disagree Disagree Neutral Agree Strongly Agree
Demonstrates openness to feedback
Shows initiative in learning
Effectively manages stress
Adapts to new situations
Overall Readiness for Independent Practice
Additional Comments or Recommendations
Should be Empty:

Select theme:

Rows	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Demonstrates openness to feedback
Shows initiative in learning
Effectively manages stress
Adapts to new situations