Performance Appraisal Evaluation Form

Employee Name : Employee Code :

Designation : Department :

Reporting Manager : Evaluation Period :

Employment Status : Probation/Permanent Date :

Sr.
N Generic Factors (A) Employee’s Performance Score
o.
How would you rate
Excellent Very Good Good Average Poor
1. the quality of this
(5) (4) (3) (2) (1)
employee’s work?
Not So
Extremely Very Somewhat Not at all
How Productive is the Productiv
2. Productive Productive Productive Productive
employee? e
(5) (4) (3) (1)
(2)
How much trust do
A moderate
you have in this A Great Deal A lot of A little Not any
amount of
3. employee’s ability to of Trust Trust trust trust at all
trust
make the right (5) (4) (2) (1)
(3)
decisions?
Extremely Very Not So
How proactive is this Somewhat Not at all
4. Proactive Proactive Proactive
employee? Proactive (3) Proactive (1)
(5) (4) (2)
Does this employee Extremely Somewhat Not So Not at all
Very Well
5. treat others with Well Well Well Well
(4)
Respect? (5) (3) (2) (1)
Does the employee
have complete Extremely Somewhat Not So Not at all
Very Well
6. knowledge which is Well Well Well Well
(4)
required to complete (5) (3) (2) (1)
the job?
Can the employee be
dependent on to plan Extremely Somewhat Not So Not at all
Very Well
7. & complete work Well Well Well Well
(4)
assignments as (5) (3) (2) (1)
required?
Total Score

MDXHR024 Internal Rev no: 1.0

Performance Appraisal Evaluation Form

Sr.
Special Factors Employee’s Performance Score
No.
Initiative: Is a
self-starter.
Extremely Somewhat Not So Not at all
Ability to Very Well
1. Well Well Well Well
proceed without (4)
(5) (3) (2) (1)
being told every
detail
Creativity: Extremely Somewhat Not So Not at all
Very Well
2. Contributes new Well Well Well Well
(4)
ideas & methods (5) (3) (2) (1)
Adaptability:
Response
Extremely Somewhat Not So Not at all
effectively to the Very Well
3. Well Well Well Well
changing needs (4)
(5) (3) (2) (1)
of the
department
Interpersonal
Skill: Ability to
Extremely Somewhat Not So Not at all
maintain a Very Well
4. Well Well Well Well
positive & (4)
(5) (3) (2) (1)
supportive work
environment
Communication
Skill: Exhibits
good Verbal & Extremely Somewhat Not So Not at all
Very Well
5. written Well Well Well Well
(4)
communication (5) (3) (2) (1)
skills as related
to job duties
Technical Skills:
Is proficient in Extremely Somewhat Not So Not at all
Very Well
6. technical skills Well Well Well Well
(4)
required for the (5) (3) (2) (1)
job.
Total Score

MDXHR024 Internal Rev no: 1.0

Performance Appraisal Evaluation Form
Note: Only applicable to Team Leader & above

Sr.
Leadership Factors Employee’s Performance Score
No.
Communication: Keeps Extremely Somewhat Not So Not at
Very Well
1. employees sufficiently Well Well Well all Well
(4)
informed. (5) (3) (2) (1)
Employee
Development: Extremely Somewhat Not So Not at
Very Well
2. Provides & encourages Well Well Well all Well
(4)
training/development (5) (3) (2) (1)
to employees
Delegation: Delegated Extremely Somewhat Not So Not at
Very Well
3. responsibility Well Well Well all Well
(4)
appropriately (5) (3) (2) (1)
Personal Relations:
Demonstrates good
Extremely Somewhat Not So Not at
judgement when Very Well
4. Well Well Well all Well
hiring, promotion, (4)
(5) (3) (2) (1)
termination &
evaluation decision
Leadership:
Exemplifies leadership
Extremely Somewhat Not So Not at
by motivation Very Well
5. Well Well Well all Well
employees to perform (4)
(5) (3) (2) (1)
with competency &
professionalism.
Total Score

Sr. No. Particulars Score

Generic Factors
1.
Special Factors
2.
Leadership Factors (Only for TL & Above)
3.
Total Score

MDXHR024 Internal Rev no: 1.0

Performance Appraisal Evaluation Form
1. Please list any areas where this employee is doing particularly well.

2. Please list any areas where this employee could improve.

3. Additional Comments (If Any).

Reporting Manager’s Signature: ……………………………………………………………….

HR Manager’s Signature: ………………………………………………………………………….

Date: …………………………………………………………………………………………………………

MDXHR024 Internal Rev no: 1.0