Hospital CEO Performance Evaluation Form
Evaluate a hospital CEO’s leadership, operational performance, communication, and strategic effectiveness using a structured review form.
Evaluation Details
Evaluator Name
*
First Name
Last Name
Evaluator Role / Title
*
Department / Organization
*
Evaluation Period / Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hospital / Region / Site
*
Please Select
Main Campus
East Campus
West Campus
Regional Hospital
Outpatient Center
Administrative Office
Other
CEO Performance Assessment
Overall Performance Rating
*
Needs Improvement
1
2
3
4
5
6
7
8
9
Outstanding
10
1 is Needs Improvement, 10 is Outstanding
Leadership Effectiveness
*
Needs Improvement
1
2
3
4
5
6
7
8
9
Outstanding
10
1 is Needs Improvement, 10 is Outstanding
Operational Management
*
Needs Improvement
1
2
3
4
5
6
7
8
9
Outstanding
10
1 is Needs Improvement, 10 is Outstanding
Strategic Planning
*
Needs Improvement
1
2
3
4
5
6
7
8
9
Outstanding
10
1 is Needs Improvement, 10 is Outstanding
Communication and Stakeholder Management
*
Needs Improvement
1
2
3
4
5
6
7
8
9
Outstanding
10
1 is Needs Improvement, 10 is Outstanding
Summary and Recommendations
Key strengths
*
Primary concerns or areas for improvement
*
Final recommendation / overall comments
*
Submit Evaluation
Should be Empty: