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Medical Assistant Evaluation Form Template

Streamline Your Medical Assistant Performance Reviews

Evaluating the performance of your medical assistants can be daunting without the right tools. This template helps you assess skills, competencies, and overall effectiveness, allowing for a clear evaluation of each staff member. With the ability to streamline feedback processes, enhance staff development, and ensure compliance with industry standards, you'll gain invaluable insights into your team's performance. Start using this live template to elevate your evaluation process.

Employee full name
Employee ID
Position/Title
Department/Clinic
Evaluation period start date
Evaluation period end date
Evaluation type
Probationary
Annual
Mid-year
90-day
Promotion review
Ad hoc
Reviewer full name
Reviewer role/title
Review date
Relationship to employee
Direct supervisor
Clinic manager
Physician/Provider
HR
Peer
Other
Please Specify:
Obtains and documents vital signs accurately
Not applicable
Poor
Fair
Good
Very good
Excellent
Performs phlebotomy and specimen collection safely
Not applicable
Poor
Fair
Good
Very good
Excellent
Administers medications and injections per protocol
Not applicable
Poor
Fair
Good
Very good
Excellent
Performs EKGs as assigned
Not applicable
Poor
Fair
Good
Very good
Excellent
Prepares rooms and patients efficiently
Not applicable
Poor
Fair
Good
Very good
Excellent
Applies infection prevention and aseptic technique
Not applicable
Poor
Fair
Good
Very good
Excellent
Handles and maintains clinical equipment appropriately
Not applicable
Poor
Fair
Good
Very good
Excellent
Recognizes changes in patient condition and escalates appropriately
Not applicable
Poor
Fair
Good
Very good
Excellent
Documents in the EHR accurately and on time
Poor
Fair
Good
Very good
Excellent
Manages scheduling and coordination tasks effectively
Not applicable
Poor
Fair
Good
Very good
Excellent
Supports coding and charge capture as required
Not applicable
Poor
Fair
Good
Very good
Excellent
Maintains inventory and supplies
Not applicable
Poor
Fair
Good
Very good
Excellent
Protects patient privacy and adheres to HIPAA
Poor
Fair
Good
Very good
Excellent
Completes data entry with minimal errors
Poor
Fair
Good
Very good
Excellent
Communicates clearly with patients and families
Poor
Fair
Good
Very good
Excellent
Demonstrates empathy and professionalism
Poor
Fair
Good
Very good
Excellent
Explains procedures and aftercare effectively
Poor
Fair
Good
Very good
Excellent
Communicates effectively with providers and team members
Poor
Fair
Good
Very good
Excellent
Overall patient feedback regarding this medical assistant
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Punctuality and attendance are reliable
Poor
Fair
Good
Very good
Excellent
Follows policies, protocols, and standard procedures
Poor
Fair
Good
Very good
Excellent
Manages workload and prioritizes tasks effectively
Poor
Fair
Good
Very good
Excellent
Maintains professional appearance and demeanor
Poor
Fair
Good
Very good
Excellent
Shows initiative and willingness to learn
Poor
Fair
Good
Very good
Excellent
BLS/CPR certification is current
Yes
No
Not applicable
Unknown
Uses appropriate PPE for tasks performed
Very rarely
Rarely
Sometimes
Often
Very often
Reports hazards, near-misses, or incidents promptly
Very rarely
Rarely
Sometimes
Often
Very often
Safety incidents involving the employee during this period
None
Minor near-miss
Incident without harm
Incident with harm
Not sure
Adheres to infection control policies in all settings
Poor
Fair
Good
Very good
Excellent
Meets expected workload and throughput for role
Poor
Fair
Good
Very good
Excellent
Top strengths (brief summary)
Development areas (brief summary)
Specific goals for the next review period
Recommended training (select all that apply)
Please Specify:
Overall performance rating
Poor
Fair
Good
Very good
Excellent
Ready for additional responsibilities
Yes
No
Not yet
Additional comments
Recommended employment action
No change
Promotion consideration
Merit increase consideration
Lateral development opportunity
Performance improvement plan
Extend probation
Employee comments (optional)
Reviewer typed name (acts as signature)
Reviewer signature date
Employee typed name (acts as signature)
Employee acknowledgement date
I discussed this evaluation with the employee
Yes
No
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Paper art illustration representing a medical assistant evaluation form for an article on FormCreatorAI

When to use this form

Use this form during 30/60/90-day onboarding, annual reviews, or when expanding duties (e.g., EKGs, injections). It helps clinic managers, providers, and HR spot strengths, gaps, and training needs so you can plan coaching and keep patients safe. Document performance after shadowing or skills checks; you can capture specific behaviors with an Observation form. For a full picture, pair this with a Supervisor evaluation form to align expectations across shifts and sites. The result is a clear competency checklist, consistent ratings, and proof of progress for audits or credentialing. It also helps assistants see what excellent looks like and what to tackle next.

Must Ask Medical Assistant Evaluation Questions

  1. Which clinical competencies do you perform independently, and where do you still require supervision?

    This separates safe, routine tasks from those needing oversight, so you can set targeted training and protect patient safety. It also structures your competency checklist and keeps scope-of-practice clear.

  2. How do you ensure accurate and timely EHR documentation, including orders, coding, and follow-ups?

    Clear steps reduce errors, denials, and missed care, improving continuity and billing accuracy. If you also cover front-desk tasks, align standards with the Administrative assistant evaluation form.

  3. Describe a time you managed patient flow during a high-volume clinic day. What did you do, and what was the result?

    Real examples reveal prioritization, communication, and teamwork under pressure. This helps you judge reliability and throughput without guesswork.

  4. How do you maintain infection control and safety protocols in daily work?

    Specific practices (hand hygiene, room turnover, sharps handling) show consistency, not just intent. This reduces incidents and supports compliance audits.

  5. What specific goals will you set for the next review period, and what support or training do you need to reach them?

    Concrete goals turn feedback into action and make progress measurable. You can co-create a development plan and mirror it in a Self evaluation form to track growth.

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