Referee Details Staff Name: Date of Birth: Post Applied: Referee's Name: In what capacity did you know the applicant? Questions 1. How long have you known the applicant? 2. From: To: 3. In what capacity do you know the applicant? SECTION 1 Please Critique Appropriately Please Circle Appropriately Excellent Good Average Poor Trustworthiness, Conduct, and General Character Attendance and Reliability Punctuality Inter-Personal Skills Use of Initiative Problem Solving Ability Willingness to Work Flexibly Managing Own Time Motivation, Effort and Application to Task General Approach to Service Users, Colleagues, Professionals Communication Skills (Verbal) Communication Skills (Written) Attention to Detail Acceptance of Supervision by Seniors Management of Stress Working with Vulnerable Adults The applicant will work with vulnerable older people and will be expected to practice their rights, maintain their dignity, and promote their independence at all times. Have you any reason to believe the applicant may not be able to work in a professional and safe way? Have you any reasons to doubt the applicant's suitability for employment with vulnerable adults? Is there any information that the service provider must be aware of? Print Name: Designation: Signature: Date: Δ
