Employer Interim Evaluation Form

Instructions:

Federal regulations require that all Trainees/Interns receive evaluations and feedback from their training supervisor. This assessment tool is intended to provide the Trainee/Intern with feedback concerning his or her personal progress in meeting the goals of the program, as initially outlined in the Training/Internship Placement Plan submitted with their application. Please complete this form half-way through the Trainee/Intern's program (i.e.: at the 6 month mark of a 12 month training program). Please share your assessment with the Trainee/Intern before submitting this form. Thank you.
Fields marked with an asterisk (*) are required.

  5. Supervisor: Please assess the Trainee/Intern's level on each of the following competencies:

  6. 1) Listening & observation skills:*(Required)
  8. 2) Clear communication skills:*(Required)
  10. 3) Able to complete projects independently but asks thoughtful questions when appropriate:*(Required)
  12. 4) Exhibits professional behavior:*(Required)
  14. 5) Interacts well with co-workers and is an effective and congenial member of the team:*(Required)
  16. 6) Has a positive attitude and is willing to learn:*(Required)
  18. 7) Is enthusiastic & responsible:*(Required)
  20. 8) Learns new skills quickly & uses them effectively:*(Required)