Section 3: Other
Financial contribution and workload:
1
2
3
4
5
Punctuality:
1
2
3
4
5
Attitude:
1
2
3
4
5
Flexibility:
1
2
3
4
5
Participation in group activities, meetings, projects:
1
2
3
4
5
Comments:
Comments/response from physician under evaluation:
Signatures:
____________________________________
Medical Director
Date
____________________________________
Physician
Date
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