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Performance Review

 
Facility:  
Your Name:  
Title:  
DiagnosTemps' Technologist:  
Start Date:
End Date:
Position:    
Performed exams according to imaging protocols:
   
Properly marked films, and maintained appropriate paperwork/files:
 
Communicated well with patients and promoted customer service:
 
Exhibited an understanding of the equipment:
 
Presented a good general appearance and conducted themselves in a professional manner:
 
Interacted well with physician(s) and other staff members:
 
Was this the first time this Technologist has worked at your facility?
 
Was there an orientation prior to the start date?
 
Would this Technologist be allowed to work at your facility in the future?
 
Additional Comments:  
  By submitting this form I verify that I am authorized to provide feedback on the Technologist and either directly supervised the Technologist or had direct contact with the immediate supervisor in order to discuss performance of Technologist prior to submitting this evaluation.  
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