Reference form (Nurse)

REFERENCE REQUEST FORM


Note: In order to protect the public you are free to divulge any information you have regarding criminal convictions that are relevant to this applicant's request for employment. This is provided for by virtue of the 1975 Exceptions Order to Section 4 (II) of the Rehabilitation of Offenders Act (1974).


Excellent GoodAcceptable Poor
Punctuality/Reliability
Professional Conduct/Dedication
Standard of Work/Performance
Self-Motivation/Initiative
Verbal Communication Skills
Written Communication/Paperwork Skills
Leadership Skills/Potential
Coping under Pressure
Co-operation/Teamwork
Confidence/Ability to Work
Unsupervised
Attitude to Training/Improvement
Caring Nature
Positive Role Model
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