Interview Evaluation Form

You may choose your ratings from among the following criteria:

Well Qualified (5) Candidate provides a thorough response to the question. Candidate demonstrates a
thorough understanding of the issues at hand that is more to substantially more than the job requires.
Response is well thought-out and well presented.

Qualified (4-2) Candidate provides an acceptable response to the question. Candidate’s understanding
of the issues at hand is equal to or slightly less than what the job requires. The response may not be as
complete or thorough as the well-qualified candidate’s response.

Not Qualified (2-1) Candidate fails to provide an acceptable response to this question. Candidate’s
response does not convey the level of experience/expertise required in this position. Candidate’s
response may be vague or incomplete.

Please encircle the appropriate rating vbelow:

Presentation Skills. Overall assessment of applicant’s 5-20

mins. presentation for organization and 5 4 3 2 1
stand up/facilitation skills

Understanding of the position. Assess applicant’s knowledge of

the position its requirements. 5 4 3 2 1

Relevant background/Special skills. Explore applicant’s

knowledge /training and skills. 5 4 3 2 1

Professional Impression. Considers self-confidence, maturity

and presence to assess the candidate’s 5 4 3 2 1
level of professionalism.
Motivation/Initiative. Analyze applicants ability to think and
act independently and goal 5 4 3 2 1
orientation.(Why does this person want to
work at the company.)
Interpersonal/Communication Skills. Assess ability to express
ideas and thought clearly as well as 5 4 3 2 1
experiences involving patient and patient
care.
Organizational fit. Assess applicant’s responsiveness to change,
tolerance for ambiguity. (ex. How will you 5 4 3 2 1
react to patients who are protesters or
adamant?)

Overall evaluation. 5 4 3 2 1

Please add comments below:

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Name and Signature of Interviewer:

Sample questions: