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Nurse Evaluation 

How did our nurse do at your facility?

We Want To Hear About It!

Your feedback is helpful to us.

Continuous improvement is an important part of our mission. We look forward to hearing your thoughts.

Employee Information
Information about Your Most Recent Temporary/Contract Employee
Name * Required
First Last
Position Title * Required
Assignment Start Date * Required
MM slash DD slash YYYY
Assignment End Date * Required
MM slash DD slash YYYY
Evaluation
Evaluation of the Employee's On-the-Job Performance
Match with requested skills/experience
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Quality of work performed
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Quantity of work performed
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Interpersonal skills
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Dependability
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Initiative and motivation
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Positive attitude
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Overall rating
- Excellent
- Good
- Average
- Needs Improvement
- N/A
Would you request this employee again?
- Yes
- No
Additional Comments
Information About You
Your Name * Required
First Last
Your Title * Required
Your Company * Required
Your Email * Required
Phone
This field is for validation purposes and should be left unchanged.

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Email * Required
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Questions / Comments
Phone
This field is for validation purposes and should be left unchanged.

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KPG Nursing

SCOTTSDALE
7135 East Camelback Road, Suite 230
Scottsdale, AZ 85251

(855) 574-4325

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