FINAL PROBATION ASSESSMENT FORM FOR PROFESSIONAL SERVICES AND RESEARCH STAFF 

Individuals involved in the probationary process are responsible for maintaining the confidentiality of the information in this document, for the purpose of this process.

Name of probationer	Role title 	Faculty / Department / NSI	

Date of appointment	Duration of probationary period 	Date of review	

Name of reviewing manager	Role title of reviewing manager 	

Section 1

Final overall assessment of performance by reviewing manager against the following criteria:	
Demonstration of required skills and knowledge for the role		
Performing duties to an acceptable standard according to the requirements of the role (quality and volume of outputs)		
General contribution to projects (if relevant to role)		
Working relationships with others (including acting as a positive role model and engendering a culture of mutual respect)		
Attendance and timekeeping		

Section 2
Relevant to clinical researchers, research nurses and midwives and allied health professionals in the School of Clinical Medicine and in other schools only.
This section should be completed by the probationer’s Clinical Director

Name of Clinical Director  	NHS Trust / Body  	

Has the probationer received an NHS appraisal? 	Y / N 	
Has the individual been subject to any disciplinary action or formal proceedings under their honorary clinical contract including, any NMC/HCPC referral? 	Y / N 	
If yes, please provide detail 	 	
Summary of clinical competency and commitments 	 	
Signature of Clinical Director  	 	Date 	 	

Section 3

Outcome of assessment by reviewing manager (select as appropriate)	
Confirm appointment	☐	Extension of probationary period	☐	Termination of appointment 	☐	
Period of extension (if relevant)	Date:	
Signature of reviewing manager		Date		

Section 4

Probationer comments		
Signature of probationer		Date