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Doctor's Name
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Start Date
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Check-In Date
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Conducted By
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Please rate the associate on each of the following performance areas.
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Patient Connection & Communication
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Clinical Outcomes
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Documentation & Charting
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Care Plan Adherence
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Team Collaboration
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Engagement in Practice Growth
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Performance Notes
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What wins or improvements are you most proud of so far?
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Where do you feel you're currently being challenged?
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What do you need from leadership to feel more supported or successful?
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Goal #1
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Focus Area
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Goal
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Deadline
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Support Needed
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Goal #2
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Focus Area
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Goal
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Deadline
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Support Needed
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Goal #3
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Focus Area
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Goal
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Deadline
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Support Needed
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