Title Page

  • Date and Time Of Discussion

  • First and Last Name

  • Payroll Number

  • Position Title

  • Employment Status

  • Department

  • Team / Area of work

  • HR Manager / Manager / Supervisor

  • HR Manager / Manager / Supervisor title

  • Is your manadatory training up to date?

  • Are all mandatory vaccinations up to date?

  • Working from home checklist in place/up to date?

General Information, Performance and role clarity

  • Is your role description current and does it accurately reflect your role purpose and key accountabilities?

  • Do you understand your responsibilities & obligations regarding all workplace safety and well-being standards?

  • Discuss where your role fits within the Corporate Services Division, Department of Health.

  • Discuss your role and responsibilities and how they contribute to frontline healthcare for Queensland.


  • REFERENCE: Rating Guidelines
    [This is an example of how you can use iAuditor to include reference images in your templates to assist with assessment]


Health and wellbeing check

  • Do you feel you are managing your current workload?

  • Do you have ideas on how you can better manage your workload?

  • What can I do as your manager to better support you?

  • Do you have any upcoming leave planned?

  • Do you understand what support pathways are available?

Performance Assessment

  • Attendance

  • Job Knowledge and Skills

  • Quality of Work

  • Initiative and Motivation

  • Teamwork

  • General Conduct

  • Discipline


  • • Look at the total score above and select the relevant overall performance rating.

  • Reference Guide

  • Special task taken up or commendation obtained by the employee during the appraisal period

  • Overall comments on performance

  • Additional comment / info from employee


  • Full Name and Signature of Employee

  • Full Name and Signature of Supervisor / HR Manager

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.