Criterion-Referenced Interview Form
Document interview details, evaluate competencies against criteria, and record summary judgments and next actions.
Interviewee Full Name
*
First Name
Last Name
Date of Interview
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Interviewer Name
*
First Name
Last Name
Role or Criterion Evaluated
*
Competency Assessment (Rate each criterion)
*
Rows
Score (1-5)
Knowledge
1
Skills
2
Behavior
3
Communication
4
Supporting Evidence / Observations
Summary Judgment
*
Next Steps / Recommendations
Overall Outcome
*
Meets Criteria
Partially Meets Criteria
Does Not Meet Criteria
Additional Comments (optional)
Submit
Should be Empty: