Dietitian and Nutritionist appraisal form
This free sample/template/form of job performance appraisal include information as follows:
1. Employee Details
• Employee Name
• Review Period
• Date of joining
• Review Date
• Line Dietitian and Nutritionist
2. Key duties/responsibilities of Dietitian and Nutritionist
State your understanding of your main duties and responsibilities of Dietitian and Nutritionist, for examples:
• Purchase food in accordance with health and safety codes.
• Select, train and supervise workers who plan, prepare and serve meals.
• Manage quantity food service departments or clinical and community nutrition services.
• Coordinate diet counseling services.
• Inspect meals served for conformance to prescribed diets and standards of palatability and appearance.
• Develop curriculum and prepare manuals, visual aids, course outlines, and other materials used in teaching.
• Prepare and administer budgets for food, equipment and supplies.
You should design a table for this area that include columns: No, duties, weight, core, comments.
3. Key result areas (KRAs) of Dietitian and Nutritionist
Using the 4-point scale below, please assess your employee performance in the following areas:
• 4 – Performance was always successful, consistent and respectable and at times clearly superior and exceeding standards.
• 3.5 – Performance was at most times clearly superior and exceeding standards.
• 3 – Performance was successful, consistent, and respectable in every regard with few exceptions.
• 2.5 – Performance at times was inconsistent and did not meet standards.
• 2 – Performance at most times was inconsistent and did not always meet standards.
• 1 – Performance was overall unsuccessful and unacceptable with regard to expectations and the requirements of the position.
Then, you can create a table with columns: No, KRAs, weight, performance score, descriptions.
4. Job objectives of Dietitian and Nutritionist
List the objectives you set out for your staff (Dietitian and Nutritionist) to achieve in the past 12 months (or the period covered by this appraisal) with the measures or standards agreed – against each comment on achievement or otherwise, with reasons where appropriate.
Score the performance against each objective (1-3 = poor, 4-6 = satisfactory, 7-9 = good, 10 = excellent):
Then you create a table with columns: No – Objectives – Measure/standard - Score - Comment
5. Job competencies
Discuss and agree the skills, capabilities and experience required for competence in current role, and if appropriate, for readiness to progress to the next role or roles.
Using the 4 point scale below, fill up the following table:
• 4 – Exceeds expectations
• 3.5 – Somewhat Exceeds Expectations
• 3 – Meets expectations
• 2.5 – Somewhat meets expectations
• 2 – Less than expectations
• 1.5 – Somewhat less than expectations
• 1 – Inadequately short of expectations 4
Core Values And Leadership Skills
• Results Orientation [e.g. quality of delivery].
• Customer Focus – internal as well as external.
• Leadership Qualities (e.g.initiative , integrity, enthusiasm and zeal, instilling trust, stretching the goals, caring and sharing , interested in people development).
• Organizational alignment [e.g. corporate initiative, acceptance of change].
• Communication (e.g. Written and verbal communication, presentation skills, facilitation skills).
• Problem Solving.
• Team work.
• Self-confidence (e.g. .taking on new responsibility, confronting and dealing with issues and problems with confidence, risk taking ability).
• Professional Demeanor and Appearance.
• Openness to Feedback and Suggestions.
• Time management.
6. Career development of Dietitian and Nutritionist
Discuss and agree (as far as is possible, given budgetary, availability and authorisation considerations) the training and development support to be given to help the appraisee meet the agreed objectives above.
7. Overall rating of Dietitian and Nutritionist:
• Fully Competent
• Continued Development
• New to Position
Name of Dietitian and Nutritionist
Appraisal acceptable to Employee: Yes / No Date
HR Dietitian and Nutritionist’s Signature
Comments, if any
New Title (if applicable)
Distribution: (1) Copy to HR departmental Personnel File (2) Copy to line Dietitian and Nutritionist. (3) Copy to Dietitian and Nutritionist / Supervisor.
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