About this template
A school nurse performance evaluation form is an essential tool for principals, administrators, and health services coordinators to systematically assess the competency, reliability, and effectiveness of school nurses. This structured evaluation helps maintain high standards of student healthcare, medication administration protocols, emergency response readiness, and communication with parents and staff.
The form collects targeted performance ratings and qualitative feedback across key clinical and administrative domains, including daily health office management, student chronic condition care, documentation accuracy, and professional collaboration. Reviewers can easily document specific achievements and areas for professional growth.
Streamline your annual review process and maintain clear personnel records using Doc2Form to instantly deploy this template as a Google Form. Site administrators and nursing supervisors can effortlessly gather feedback, calculate ratings, and securely store evaluation results for credentialing and development planning.
Key features
- Evaluate clinical skills and administrative organization in one review
- Standardize scoring for health office operations and student care
- Include dedicated sections for constructive feedback and goal setting
- Capture electronic signatures and review dates easily
- Deploy instantly as a Google Form for immediate completion
Use cases
Annual performance reviews for staff registered nurses and licensed pā¦
Annual performance reviews for staff registered nurses and licensed practical nurses
Mid-year check-ins and professional development goal tracking
Health services evaluations by school principals and district nurse cā¦
Health services evaluations by school principals and district nurse coordinators
Contract renewal assessments for school-based healthcare personnel
What this form collects
- Employee Name (Short answer)Enter the full name of the school nurse being evaluated.
- School District / Facility (Short answer)Specify the name of the school and district or educational institution.
- Review Date (Date)Select the date this performance evaluation is conducted.
- Evaluation Period (Dropdown)Select the timeframe covered by this performance review.
- Clinical Competence & Patient Care (Linear scale)Rate the nurse's clinical skills, adherence to medical protocols, and quality of student care (1 = Unsatisfactory, 5 = Excellent).
- Health Office Organization & Documentation (Linear scale)Rate accuracy in maintaining health records, managing medication logs, and keeping supplies organized.
- Communication & Professional Collaboration (Linear scale)Rate communication with parents, teachers, administrators, and external medical providers.
- Emergency Response & Crisis Management (Linear scale)Rate preparedness and performance during medical emergencies, accidents, or health crises.
- Strengths and Notable Achievements (Paragraph)Highlight specific areas where the nurse excels or has made significant positive impacts.
- Areas for Growth and Professional Development (Paragraph)Note any areas requiring improvement, additional training, or updated certifications.
- Evaluator Comments (Paragraph)Provide overall summary remarks regarding this evaluation period.
- Evaluator Signature / Name (Short answer)Type your full name and title to confirm completion of this evaluation.
- Employee Acknowledgment (Short answer)Type your full name to acknowledge receipt and review of this performance evaluation.
FAQ
Who typically completes this school nurse evaluation form?
This form is usually completed by the school principal, site administrator, or district nursing supervisor who oversees the nurse's daily administrative and professional duties.
Can I customize the evaluation criteria and rating scales?
Yes. Once you convert this template into a Google Form using Doc2Form, you can fully edit questions, adjust rating scales, and add department-specific criteria to match your district's standards.
How do I collect signatures on the evaluation?
The form includes text fields for both the evaluator and the employee to type their names and review dates to acknowledge completion of the performance appraisal.
Can I share the completed evaluation with the nurse?
Yes. Google Forms allows you to automatically send a copy of responses to the respondent or export results to a document for personnel files.
How does Doc2Form help me use this template?
Doc2Form instantly converts this structured outline into a fully functional Google Form in your Google Drive, saving you from manual setup and formatting.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.