Coach Supervision Form
Please complete all sections that are applicable
Employee Name
First Name
Last Name
Supervisor Name
First Name
Last Name
Date
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Month
-
Day
Year
Date
Time
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Length of Supervison
Location of work
Community
Metro ED
OSU ED
ATI
Warmline
Other
1
Not Satisfied
Somewhat Satisfied
Satisfied
Very Satisfied
N/A
Notes/Survey Submitted in Timely Fashion(Within 24 hours)
2
3
4
5
6
Notes Content
7
8
9
10
11
Meeting Peer Support/Warmline Expectations
12
13
14
15
16
Coaching Performance
17
18
19
20
21
Scheduling Assessments in a timely fashion
22
23
24
25
26
Coaches' areas of concern (Satisfied with workload, number of peers, number of hours, etc)
Coaches' success story
Team Lead suggestions for growth
Course of action
Additional Comments
Submit
Should be Empty: