RAG Evaluation Faithfulness Assessment Form
Assess how faithfully a RAG response uses retrieved context, records the evaluation outcome, and captures supporting review notes.
Evaluation Details
Model / prompt or test case name
*
Evaluator name or team
*
Evaluation date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Evaluation type
*
Initial review
Regression test
A/B comparison
Manual audit
Other
Faithfulness Assessment
Overall faithfulness outcome
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Faithful
Partially Faithful
Not Faithful
Overall faithfulness rating
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Not faithful
1
2
3
4
5
6
7
8
9
Fully faithful
10
1 is Not faithful, 10 is Fully faithful
Assessment criteria
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Rows
Yes
Partly
No
Answer is grounded in retrieved context
1
2
3
Unsupported claims appear
4
5
6
Citations/support align with the response
7
8
9
Key retrieval context was used correctly
10
11
12
Evidence and Review Notes
Supporting Evidence Summary
*
Failure Modes or Hallucination Notes
*
Reviewer Recommendation
*
Pass
Needs Revision
Reject
Escalate
Other
Submit Assessment
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