In this form another GP carries out an appraisal on another GP. The aim of this is to improve the services offered to all patients. Theinformation given is used to assess the GP’s competencies and so better his skills. The forms are clear- cut and easy to fill out.
Name of the GP being appraised: ____________________________________________
Address: ________________________________________________________________
Tel: ____________________________________________________________________
Mobile: _________________________________________________________________
Email: __________________________________________________________________
Location of their practice or hospital: _________________________________________
Name of GP carrying out the appraisal: ________________________________________
Address: ________________________________________________________________
Tel: ____________________________________________________________________
Mobile: _________________________________________________________________
Email: __________________________________________________________________
Describe the practice or hospital in which you work: _____________________________
_________________________________________________________________________
_______________________________________________________________________
Describe your duties: ______________________________________________________
________________________________________________________________________
________________________________________________________________________
Describe your responsibilities: _______________________________________________
_________________________________________________________________________
_______________________________________________________________________
Give details of your qualifications: ___________________________________________
________________________________________________________________________
________________________________________________________________________
Describe your achievements over the last year: __________________________________
________________________________________________________________________
________________________________________________________________________
Describe drawbacks of the last year: __________________________________________
_________________________________________________________________________
_______________________________________________________________________
Describe your patient care: _________________________________________________
__________________________________________________________________________
______________________________________________________________________
Describe your interaction with other members of the hospital: ______________________
____________________________________________________________________________________
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