Title Page

  • Document No.

  • Assessment for (Employee name)

  • Employee AKA Name

  • Job Title

  • Department

  • Assessment carried out by

  • Date form sent

  • Date of employment commencement

  • Conducted on

  • Location


  • Passport style picture of employee


  • Improvement Required – Demonstrates little aptitude, and/or inappropriate attitude, little evidence of competency, skill, knowledge or experience
    Average – Demonstrates reasonable aptitude, evidence of the appropriate behaviour, reasonable evidence of competency, skill, knowledge and experience
    Good – Demonstrates an appropriate aptitude level, the appropriate attitude and behaviour, evidence of competency, skills, knowledge and experience
    Excellent – Demonstrates all the requirements of a Good rating, plus exceeds requirements in terms of aptitude, attitude, and behaviour, skills, knowledge and experience

  • Job Knowledge

  • Quality and accuracy of work

  • Efficiency

  • Attendance

  • Time keeping

  • Work relationships (team work and interpersonal and communication skills)

  • Where any areas require improvement give details below.

  • Outline the employees views on the job, work environment and working conditions.

  • Summary of employees overall performance.

  • Is the employees appointment to be confirmed?

  • If Yes please specify new salary (£/annum)

  • Date Effective from

Probationary period extention

  • Should the employees probationary period be extended to allow time for improvement

  • Please specify the date on which the employee will complete the extended period and specify the improvements required and how this will be achieved

  • Select date

  • Improvements required

  • How will this be achieved

  • Was this placement an internal recommendation? If so, who should the recommendation fee to be paid to?

  • Enter recipient name

Sign off

  • Employee signature

  • Manager signature

  • Please return this form to Karen Stubbings, HR Department via email Karen.stubbings@westwayservices.com

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.