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Performance Review Template for Practice Teams (Fillable and Printable)
A performance review rates a team member against clear criteria for their role, with examples, then sets goals for the next period. Pick a role below (provider, injector, front desk, medical assistant or practice manager), rate each criterion from 1 to 5, add comments and goals, then print or save the form. What you type stays in your browser.
Prepared by Prospyr · Reviewed October 11, 2026 · Free, no sign-up, runs in your browser
Changing the role swaps the criteria. Ratings you entered for other roles are kept until you reload.
Everything you type stays in your browser. Nothing is sent, saved or added to the page address, and it clears when you close or reload the page. Print or save as a PDF before you leave.
Average rating (simple mean of rated criteria)
– of 5, 0 of 10 rated
Make each goal specific, with a measure and a date.
A documentation aid, not legal or HR advice. Keep reviews factual, apply the same standards to every team member in a role, and check your state's employment rules before acting on a review.
Reviewing a provider's numbers? See sales by provider in Prospyr reporting →
How to run the review
- Rate each criterion on your own before the meeting and write one example for every rating.
- Ask the team member to think about their own ratings first, then compare.
- Agree on two or three goals with a measure and a date.
- Print or save the form, have both people sign, and keep it with their record.
Rating scale: 5 consistently exceeds expectations, 4 often exceeds, 3 meets, 2 sometimes below, 1 below expectations.
Keep it fair and factual
Stick to observed work and specific examples, use the same criteria for everyone in the same role, and review on a regular schedule. The criteria here are general; adjust them to match your own protocols and job descriptions. Clinical decisions and scope of practice stay with your medical director and your state rules, not with this form.
Related tools
Plan pay changes with the salary increase calculator, the bonus calculator and the commission calculator. To see what a departure would cost you, use the employee turnover cost calculator.
Frequently asked questions
What should a performance review for a practice team include?
The team member and review period, criteria for the role, a rating and a specific example for each, strengths, areas to develop, goals for the next period, a place for the team member's comments, and signatures. This template includes each.
Are the criteria different for providers and front desk?
Yes. Choosing a role loads criteria written for it, such as charting and protocol adherence for providers and injectors, or scheduling accuracy and payment handling for front desk. Four shared criteria, such as reliability and teamwork, apply to every role.
How is the average rating calculated?
It is the simple mean of the criteria you rated, out of 5. Criteria left as not rated are skipped. It is a summary to start the conversation, not a score to base pay on automatically.
How do I write good goals?
Make each goal specific, with a measure and a date, for example 'complete the updated consent workflow training by March 31'. Two or three goals a period are easier to follow than a long list.
Is my text saved or sent anywhere?
No. Names and comments stay in your browser. They are not sent to Prospyr, not saved and not added to the page address. They clear when you reload, so print or save the review as a PDF first.
Can I tie reviews to pay?
That is your decision. If you do, write down how, and apply it the same way to everyone in a role. See the commission, bonus and salary increase calculators for the arithmetic, and check your state's employment rules before acting on a review.
Sources and scope
A documentation aid, not legal or HR advice. The criteria are general and meant to be adapted. Employment rules differ by state; check them before acting on a review.