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Appraisal Form
Full Name
Professional Registration Number
Have you been appraised within the last 12 months?
Yes
No
Full Name of Appraiser
In order to work within the NHS you will need to be appraised annually by a Senior Practitioner of the same discipline, this person will become your “appraiser”. Please give the details of the Senior Practitioner you have made arrangements with to act as your appraiser.
Position and Grade of Appraiser
Professional Registration Number of Appraiser
Date of Appraisal
Date of Next Appraisal
Appraisal Statement - Select if you agree with the following statements
I confirm the appraisal was within an "Approved NHS Appraisal System" and includes 360 degree feedback as well as feedback from patients.
I confirm that I maintain a written portfolio of my professional experience and attendance at proffessional development courses, which also includes a written and agreed "Personal Development Plan" as agreed at the appraisal.
Applicant/Candidate's Email
Date
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