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Medacs Reference Form -Radiographer

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Maine Maruzzo
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6 views

Medacs Reference Form -Radiographer

Uploaded by

Maine Maruzzo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Name of Referee

Name of Organisation

Position held within your


Organisation

This person has given your name as a reference in their application. I would be most grateful if you would complete the
questions below and return to me by email.

APPLICANT (Name of candidate):

POSITION APPLIED FOR: Radiographer


DATES OF EMPLOYMENT: (start and
finish, please include month and year)

How do you know the applicant (professional capacity) Supervisor Manager Senior Doctor /
Please note colleagues cannot provide a reference, you must be a direct Consultant
supervisor.

What is your opinion of the applicant character with regard to:

Excellent Good Fair Poor


Honesty

Reliability

General Conduct

Professional/Technical competence

Ability to accept responsibility

Communication Skills

• Sick Leave - number of days taken per year: Number of Occasions:

• Is the applicant subject to/or have they had any disciplinary action against them? Yes / No

• From your knowledge, which category would you place her/him in relation to the post applied for?

Excellent Very Good Good Fair Poor

• Would you employ this individual again? Yes / No

If not, please provide details/reason:

• Any other comments

Date: _ _ Seal/Company Stamp:

Signature: _ _ _ _ _

Thank you for your assistance in this matter.

Please make sure that you use your hospital stamp / Seal or copy and paste onto headed paper.

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