Student Health Center Clerical Assistant Self Evaluation Form

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Name_______________________________________________ Date______________
Student Health Center Clerical Assistant
Self Evaluation Form
Evaluate your work experience this year at the Student Health Center as a Clerical
Assistant. Rate each category listed below using a scale between 0 and 5.
0 = Held no personal value as a work experience, no personal growth, not applicable to
present career goals
1 = Held minimal value as a work experience, no significant personal growth, probably
not applicable to present career goals
2 = Held a small value as a work experience, small amount of personal growth, vague
applicability to present career goals
3 = Held moderate value as a work experience; moderate, but significant personal
growth; experience applicable to present career goals
4 = Held substantial value as a work experience, considerable personal growth,
substantial applicability to present career goals
5 = Held remarkable value as a work experience, outstanding contribution to personal
growth, unequivocal applicability to present career goals
Transferable skills (skills you will be able to utilize in your future career)
_____Communication skills (with patients, staff members, or other student workers)
_____Interpersonal skills (with patients, staff members, or other student workers)
_____Team work (working well with others to accomplish goals and tasks of clinic)
_____Accountability (arriving to work on time, fulfilling job responsibilities as assigned)
_____Phone etiquette (with patients, other offices, and Truman faculty/staff members)
_____Attained experience about a clinic setting through this position
_____Attitude (remaining positive, open to new ideas, eager to learn new skills)
_____Work ethic (not superimposing personal belief system on others, an accountable
and dependable team member, makes patient needs a priority concern)
_____Job performance (working within scope of training, working efficiently,
completing tasks as assigned, following job description)
_____Attire (paying attention to professional appearance, following Health Center dress
code for student workers)
_____Professionalism (cohesive representation of all evaluated categories)
Created by Christina Davis, Revised 08-2007 CD
Name_______________________________________________ Date______________
Student Health Center Clerical Assistant
Self Evaluation Form
Evaluate your work experience this year at the Student Health Center as a Clerical
Assistant. Rate each category listed below using a scale between 0 and 5.
0 = Held no personal value as a work experience, no personal growth, not applicable to
present career goals
1 = Held minimal value as a work experience, no significant personal growth, probably
not applicable to present career goals
2 = Held a small value as a work experience, small amount of personal growth, vague
applicability to present career goals
3 = Held moderate value as a work experience; moderate, but significant personal
growth; experience applicable to present career goals
4 = Held substantial value as a work experience, considerable personal growth,
substantial applicability to present career goals
5 = Held remarkable value as a work experience, outstanding contribution to personal
growth, unequivocal applicability to present career goals
Transferable skills (skills you will be able to utilize in your future career)
_____Communication skills (with patients, staff members, or other student workers)
_____Interpersonal skills (with patients, staff members, or other student workers)
_____Team work (working well with others to accomplish goals and tasks of clinic)
_____Accountability (arriving to work on time, fulfilling job responsibilities as assigned)
_____Phone etiquette (with patients, other offices, and Truman faculty/staff members)
_____Attained experience about a clinic setting through this position
_____Attitude (remaining positive, open to new ideas, eager to learn new skills)
_____Work ethic (not superimposing personal belief system on others, an accountable
and dependable team member, makes patient needs a priority concern)
_____Job performance (working within scope of training, working efficiently,
completing tasks as assigned, following job description)
_____Attire (paying attention to professional appearance, following Health Center dress
code for student workers)
_____Professionalism (cohesive representation of all evaluated categories)
Created by Christina Davis, Revised 08-2007 CD
Please answer the following questions:
How could the Student Health Center staff have better facilitated your personal growth
through your position as a clerical assistant?
How could the Student Health Center staff have better assisted you in gaining
transferable skills applicable to your future career?
Would you recommend your position as a clerical assistant to other students on campus
looking for a rewarding scholarship/work study job?
Overall Evaluation
On a scale of 1-10, with 1 representing “This position offered few skills that I will use
in my future career” to 10 representing “This position offered multiple opportunities
to refine skills or learn new skills that I will use in my future career” please
checkmark your overall evaluation:
|_______|_______|_______|________|_______|_______|_______|_______|_______|
1
2
3
4
5
6
7
8
9
10
Thank you. We appreciate your feedback.
Created by Christina Davis, Revised 08-2007 CD

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