Virtual Assistant Feedback Form This form will help us to know your thoughts on how we can improve your experience at Bottleneck Medical Virtual Services. Note: Fields marked with an asterisk (*) are required. Virtual Assistant* First Last Email Address*(Enter the email address where you would like your completed form to be sent.) Name of Client*(Please submit separate forms if you have multiple clients.) First Last Date Today* MM slash DD slash YYYY 1. Delegation*How well were your job role and responsibilities delegated to you? Consider how well you understood what is expected of you to perform. Extremely Poor Poor Average Good Excellent 2. Productivity*How well are the systems and processes laid out? Consider their efficiency and whether they are making your work easy. Extremely Poor Poor Average Good Excellent 3. Growth Opportunities*How much opportunity for growth does your client give you? Consider how you have improved as a working professional in your field of expertise. Extremely Poor Poor Average Good Excellent 4. Company Culture*How well do you think is the kind of culture that you have with your client? Consider the ability you currently have to contribute, develop and/or carry out new ideas or methods. Extremely Poor Poor Average Good Excellent 5. Trustworthiness*Does your client understand the specifics of your job role? Consider your client’s degree of required supervision, ability to delegate responsibilities and desire for you to be accountable. Extremely Poor Poor Average Good Excellent 6. Judgment*Does your client exercise the ability to decide, correct or choose the best course of action when some decision must be made? Consider ability to evaluate facts, make timely decisions and use logic to identify, solve and prevent problems. Extremely Poor Poor Average Good Excellent 7. Relationships with People*How well does your client work with you and others? Consider respect and courtesy shown, supervision and overall attitude exhibited. Are manners and sociability appropriate to the job responsibilities? Extremely Poor Poor Average Good Excellent 8. Attendance and Punctuality*How well do you get to hear and receive help from your client? Consider your client’s observance of your work schedules, breaks, project deadlines and notice of absence. Extremely Poor Poor Average Good Excellent 9. Accountability*How prepared are you to perform the job requirements? Consider frequency of Internet connectivity and power outage problems, availability of backup WIFI or alternate work location, quality of equipment and equipment upkeep (headset, monitor, computer). Extremely Poor Poor Average Good Excellent 10. Communication*How well does your client communicate? Consider your client’s listening skills, ability to express ideas (both orally and in writing) and ability to provide relevant and timely information to you and others. Extremely Poor Poor Average Good Excellent Things You Are Grateful For*What can you say about your work with us for this review period?Suggestions for Improvement*What is the action that you would like to take based on your experience with the Bottleneck Medical Virtual Services community and with your client? Testimonial (Optional)Would you like to give Bottleneck Medical Virtual Services a testimonial? Use the space below to share your story with others on our website or social media.Upload your image for the testimonial (Optional)We would love to include your headshot in your testimonial.Max. file size: 50 MB.Other Feedback (Optional)Lastly, would you recommend Bottleneck Medical Virtual Services to your friends, family and/or colleagues?* Yes No Thank you for taking the time to send us your feedback. For inquiries, feel free to contact [email protected]. EmailThis field is for validation purposes and should be left unchanged.