BRG SORT Performance Appraisal Form for Admissions 2024- Class of 2026 (Starting Jan 2025)
Applicants for the Baton Rouge General School of Radiologic Technology are required to submit a minimum of two (2) completed Performance Appraisal Forms for the Admissions year that they are applying. More than two (2) are allowed but 2 is the minimum required for the application process for the applicant to be considered complete.

This 2024 Performance Appraisal Form is being sent to you to complete as a request to validate current skill or competence levels and evaluate the applicant for BRG SORT Admissions to the Professional Program in Radiologic Technology (Medical Imaging) for the Class of 2026 (Admissions starting Jan 2025). To serve as an Evaluator for the Applicant, you must have been an Employer (Supervisor or above), Direct Supervisor, or a College Instructor/  Professor/  Clinical Coordinator/  Director/  Dean of the Applicant within the past 2-4 years.

By sending this form for the Evaluator to complete, the applicant agrees to waive their rights to the completed  Performance Appraisal Form by the individual completing it below. The applicant and the evaluator also should know and understand that the Form will ONLY be viewed by the SORT Program Director and 2024 Admissions Committee. It is the BRG SORT Admission Committee's request that the form below be completed for the applicant with caution, critical and clear recommendation evaluation, and the most accurate understanding of the applicant's abilities within the setting that they are applying to. The medical environment is one that requires good written and oral communication, excellence in appearance and hard work, and quality critical thinking for the success of the patient's outcome. This program that the applicant is applying for is 2 years full time and is rigorous in academic standards. We strive to create and continue the tradition of excellence within each student group through graduation and successful national boards testing. Our ultimate goal is to provide quality entry level professionals to the medical community that represent the program well. This Performance Appraisal Form for the applicant is designed to assist the Admissions Committee in doing just that for each admissions year.

Please complete the entire BRG SORT Performance Appraisal Form below and submit before the deadline of 8/30/24 at 4pm for this to be included within the Applicant's Master file for the Admission year of 2024 (Class of 2026). Any form that is not submitted by the deadline or is submitted incomplete will NOT be included or counted for the Applicant. If you as the evaluator, would like to submit additional information (positive or concerns) to the BRG SORT Admissions Committee or the Program Director regarding the applicant. Please feel free to email the Program Operations Coordinator, Langley Britt, directly at lan618@brgeneral.org at any time. 

NO Performance Appraisal Forms should come directly from ANY Applicant- this will VOID the FORM and will be referred to the Program Director for violation of the Admissions Process.

You will receive an email following the completion of this Form with your responses for your records. We may contact you (via email or phone) for additional clarification or verification of completion if necessary, with parameters of evaluation submitted on applicant. We appreciate your help with this evaluation of the applicant and assistance within the application process for Baton Rouge General School of Radiologic Technology!

Deadline for submission of this Form: 8/30/24 at 4pm

Please email Langley Britt- BRG SORT Program Operations Coordinator, if you have any questions or need help in completing at lan618@brgeneral.org. 
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Email *
Name of the Individual Completing this Form (Evaluator):
Mailing Address of the Evaluator: (Street, City, State, and Zip; Will only be used for thank you letter only)
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Phone Number for Evaluator: (Business/Work/Office/Personal Phone) (Will only be used for contacting for clarification or verification if needed.)
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Name of Individual that you are completing this Form for (Applicant for BRG SORT Admissions):
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Mailing Address of the Applicant: 
(Street, City, State, and Zip; for secondary legal confirmation of the correct Application Candidate)
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In what capacity have you, as the Evaluator, known the Applicant? (Select All that apply)
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Required
How long have you known the Applicant in the above listed capacity?
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Personal Characteristics: Comparing the Applicant to others of similar background or experience, Please rate the Applicant in EACH of the categories below:
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Not Appropriate; Have Concerns
Appropriate
Exceeds Peers in Appropriateness
Speech (Oral Communication) and Decorum (Social Engagement/Behavior)
Grooming and Personal Hygiene
Level of Maturity/ Self Awareness
Personal Responsibility/Accountability
Promptness/Meeting Deadlines
Absenteeism
Overall Ability toward Completion of Given Task
How does the applicant receive assertive instruction, direct corrective feedback, or respond when changes in behavior or skills are needed? Pls provide an example.
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Performance Characteristics: Comparing the Applicant to others of similar background or experience, Please rate the Applicant in EACH of the categories below:
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Inadequate
Below Average, Meets minimum
Average
Above Average
Excellent, Top Performer
Quality of Work
Quantity of Work
Organization or Structure of Work
Written Communication
Learning Skill/Ability to Learn New Things
Ability to Retain Skills Learned and Build on those
Ability to work well with others/In Team Environment
Flexibility/Ability to Deal with Change
Initiative/Self-Directed/Resourceful
Ability to Deal with Stress
Time Management/Task Management under deadline
Critical Thinking Skills/Ability to adapt
Ability to Handle Feedback/Constructive Criticism
Ability to Assess Information Given and Perform Quickly and Efficiently
How does the applicant do in problem solving and critical thinking situations? Can they adjust and be resourceful independently? Pls provide an example.
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How does the applicant work/perform in stressful or changing environments with moderate demands on time or multitasking? Pls provide an example.
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Describe 3 strengths possessed by the Applicant that would have a positive impact in the practice of Radiologic Technology (Medical Imaging) or within Healthcare.
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Describe 1-3 areas of growth (weakness) possessed by the Applicant that would have a negative impact or cause for concern within the practice of Radiologic Technology (Medical Imaging) or within Healthcare as a whole if not addressed and improved by the Applicant over time.
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Overall, how would you rank/rate this Applicant for admissions into a rigorous professional program for Medical Imaging/Healthcare as the Evaluator?
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Additional Comments/Concerns/Reasons that as the Evaluator the Admissions Committee should consider about the Applicant:
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Evaluator's Name, Credentials, and Title
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Evaluator's Organization/Institution/Company Name and Mailing Address
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Acknowledgement Statement: 
As the Evaluator, your feedback, validation, and evaluation of the Applicant provided to the Baton Rouge General School of Radiologic Technology Professional Program will be used strictly by the Admissions Committee for the review of the Applicant for admissions into the professional program only. Additionally, the information provided must come directly from one of the qualified individuals listed above and should never come directly from any applicant. All information is kept confidential by the program and is only seen/reviewed by the SORT Registrar and Admissions Committee members. All information is blinded prior to review by the committee and is used to ensure that only qualified applicants are admitted to our program to ensure the applicant's and the program's success long term. Any Evaluator may contact the program to help provide any additional information as is pertaining to the admissions process for the healthcare profession. As an evaluator, you may be contacted by the program to provide any clarification if needed regarding this letter of Performance Appraisal/Recommendation only. The Applicant has waived their rights to see the information included within this document by sending this link/document directly to you to complete on their behalf.  

To agree to this understanding and to submit the Performance Appraisal as completed above, please type in your LEGAL NAME below and the DATE of your signature. When complete with the evaluation, then select submit.
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