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. TEAMWORK/INTERPERSONAL ABILITIES ______ Motivates and develops enthusiasm in the group.

______ Strives to create an environment that encourages teamwork and good morale. ______ Demonstrates recognition and support of the doctor and other employees. ______ Cooperates with others to facilitate efficiency and productivity. ______ Willingly considers others ideas and new methods. ______ Maintains a calm and positive outlook in stressful situations. ______ Pursues cross training and demonstrates a willingness to work in other areas of the practice, upon request, to ensure efficient, high quality workflow. COMMENTS: G. INITIATIVE & SELF-MANAGEMENT ______ Resourceful and innovative in working out solutions to problems as they arise. ______ Performs effectively with minimal supervision. ______ Aware of, and attentive to, office policies and procedures. ______ Able to make decisions with goals of the practice in mind. ______ Initiates action, acquires needed information/resources, and follows through on completion of assigned tasks. ______ Plans and organizes daily work in a systematic way, setting proper priorities. ______ Completes assignments in a timely manner, striving to meet deadlines. ______ Strives to acquire more knowledge/skills needed to increase productivity and contribution to the practice. ______ Accepts and accurately assesses instructional feedback (training information, constructive criticism, etc.) in order to improve performance. COMMENTS: H. LEADERSHIP ______ Capable of directing and coordinating an assignment/project. ______ Capable of supervising others. ______ Encourages and stimulates practical and original ideas from others. ______ Delegates authority and responsibility fairly and appropriately. COMMENTS: I. ORGANIZATION ______ Works in an orderly and organized fashion, with a neat workspace. ______ Proficiently handles more than one project at a time. ______ Functions adeptly in spite of an often hectic/unpredictable environment. ______ Adapts to changing work situations and priorities. COMMENTS: J. PATIENT SATISFACTION & COMFORT ______ Telephone manner is cheerful, interested, courteous, and tactful. ______ Strives to welcome patients and to meet their needs in a positive and responsive manner. ______ Does not engage in idle activities/conversations excessively or inappropriately in the presence of patients. ______ Demonstrates a commitment to quality service and care. ______ Takes pride in and contributes to the attractive and clean appearance of the office. COMMENTS: K. PERSONAL ______ Maintains clean, neat, and professional appearance. ______ Complies with office dress policy. ______ Strives to present a professional manner. ______ Does not allow personal affairs to interfere with performance in the office. 1

COMMENTS: OVERALL STRENGTHS: What are the employee's strengths? Has the employee met goals set during last evaluation? IMPROVEMENTS NEEDED: In what specific ways must the employee improve performance? PLANNED GOALS: What goals should the employee plan to meet for the next appraisal meeting? I have read and understand the contents of this evaluation. I understand my signature only indicates receipt of this evaluation and that I have thirty days to attach my comments. Employee Signature: Reviewer Signature: Date of Review: