Project #6

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we will keep your information safe! Feel free to contact us with any questions.
However, someone you know might need assistance and we are hoping that you could introduce us. Your referrals would mean a lot to us.
We also help customers check for their NDIS eligibility.

Thank you for the job application.

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	Poor	N/A	1	2	3
Clinical judgement and decision-making skills
Mandatory reporting skills
Ability to follow policies and procedures
Ability to lead, mentor or guide more junior staff members
Ability to manage the behaviour of patients/residents
Ability to administer medications
Observation skills and ability to de-escalate issues if required
Use of electronic based care or medication systems
Ability to manage pressure/busy workload?
Willingness to ask for help if needed

	Poor	N/A	1	2	3
How would you rate “EMPLOYEE NAME”'s punctuality and reliability?
How would you rate “EMPLOYEE NAME”'s organisational skills?
How would you rate “EMPLOYEE NAME”'s initiative?

	Poor	N/A	1	2	3
What is “EMPLOYEE NAME”'s communication with residents and families like?
How would you rate “EMPLOYEE NAME”'s relationship with colleagues?

Reference Request

NDMHS Consent Statement

Your Details

Working Relationship Details

Reference Request for

Please answer the following questions compiled by NDMHS

ABILITY TO PERFORM IN THE ROLE

Can you please rate “EMPLOYEE NAME” from 1 to 5 on the following attributes: (1 being Poor to 5 being Excellent)

WORK ETHIC

Can you please rate “EMPLOYEE NAME” from 1 to 5 on the following attributes: (1 being Poor to 5 being Excellent)

COMMUNICATION AND INTERPERSONAL SKILLS

Can you please rate “EMPLOYEE NAME” from 1 to 5 on the following attributes: (1 being Poor to 5 being Excellent)

Turn your phone sideways to answer the following questions

EMPLOY-ABILITY

Your Signature