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What Is the Name of This Form?
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Question 21

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What is the name of this form?
Name: ____________________________ Title: ____________________________
 1. Erisures audits  are consistert with  Perfoned Below  Performed As  Perfaned Above Expectation  internal audit  Expected  Expectation  stardards. \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\\text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\\text { internal audit } & \text { Expected } & \text { Expectation } \\\text { stardards. } & & & \\\hline\end{array}
Comments/Recommendations:
 2. Erisures audits  Perforned Below  Performed As  Performed Above  are timely.  Expectation  Expected  Expectation \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\\text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\\hline\end{array}
Comments/Recommendations:
 3. Ensures audits  are useful to  clients.  Performed Below  Expectation  Performed As  Expected  Perforned Above  Expectation \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\\text { are useful to } \\\text { clients. }\end{array} & \begin{array} { l } \text { Performed Below } \\\text { Expectation }\end{array} & \begin{array} { l } \text { Performed As } \\\text { Expected }\end{array} & \begin{array} { l } \text { Perforned Above } \\\text { Expectation }\end{array} \\\hline\end{array}
Comments/Recommendations:
 4. Sets appropriate  Performed Below  Performed As  Performed Above  audit priorities.  Expectation  Expected  Expectation \begin{array}{l|l|l|l}\text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\\text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation }\end{array}
Comments/Recommendations:
 5. Responds  Performed Below  appropriately to  changing  conditions in the  Performed As  Expected  Performed Above  Expectation  department and the  medical center: \begin{array}{l|l|l|l}\text { 5. Responds } & \begin{array}{l}\text { Performed Below } \\\text { appropriately to } \\\text { changing } \\\text { conditions in the }\end{array} & \begin{array}{l}\text { Performed As } \\\text { Expected }\end{array} & \begin{array}{l}\text { Performed Above } \\\text { Expectation }\end{array} \\\begin{array}{l}\text { department and the } \\\text { medical center: }\end{array} & &\end{array}
Comments/Recommendations:
 6. Interacts with  and reports to  clients in a  consultative  Eerformed Below  Performed As  Performed Above Expected  menaruer.  Expected \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\\text { and reports to } \\\text { clients in a } \\\text { consultative }\end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\\text { menaruer. } & & \text { Expected } & \\\hline\end{array}
Comments/Recommendations:
 7. Nurtures hieh-  Perfarmed Below  Perfarned As  Perfonned Above  performing tearn.  Expectation  Expected  Expectation \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\\text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\\hline\end{array}
Comments/Recommendations:
What is the name of this form? Name: ____________________________ Title: ____________________________ \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\ \text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\ \text { internal audit } & \text { Expected } & \text { Expectation } \\ \text { stardards. } & & & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\ \text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\ \text { are useful to } \\ \text { clients. } \end{array} & \begin{array} { l } \text { Performed Below } \\ \text { Expectation } \end{array} & \begin{array} { l } \text { Performed As } \\ \text { Expected } \end{array} & \begin{array} { l } \text { Perforned Above } \\ \text { Expectation } \end{array} \\ \hline \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\ \text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation } \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 5. Responds } & \begin{array}{l} \text { Performed Below } \\ \text { appropriately to } \\ \text { changing } \\ \text { conditions in the } \end{array} & \begin{array}{l} \text { Performed As } \\ \text { Expected } \end{array} & \begin{array}{l} \text { Performed Above } \\ \text { Expectation } \end{array} \\ \begin{array}{l} \text { department and the } \\ \text { medical center: } \end{array} & & \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\ \text { and reports to } \\ \text { clients in a } \\ \text { consultative } \end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\ \text { menaruer. } & & \text { Expected } & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\ \text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Evaluated by: _________________ Title: __________________ Date: ________________
Comments/Recommendations:
What is the name of this form? Name: ____________________________ Title: ____________________________ \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\ \text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\ \text { internal audit } & \text { Expected } & \text { Expectation } \\ \text { stardards. } & & & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\ \text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\ \text { are useful to } \\ \text { clients. } \end{array} & \begin{array} { l } \text { Performed Below } \\ \text { Expectation } \end{array} & \begin{array} { l } \text { Performed As } \\ \text { Expected } \end{array} & \begin{array} { l } \text { Perforned Above } \\ \text { Expectation } \end{array} \\ \hline \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\ \text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation } \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 5. Responds } & \begin{array}{l} \text { Performed Below } \\ \text { appropriately to } \\ \text { changing } \\ \text { conditions in the } \end{array} & \begin{array}{l} \text { Performed As } \\ \text { Expected } \end{array} & \begin{array}{l} \text { Performed Above } \\ \text { Expectation } \end{array} \\ \begin{array}{l} \text { department and the } \\ \text { medical center: } \end{array} & & \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\ \text { and reports to } \\ \text { clients in a } \\ \text { consultative } \end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\ \text { menaruer. } & & \text { Expected } & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\ \text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Evaluated by: _________________ Title: __________________ Date: ________________
Comments/Recommendations:
What is the name of this form? Name: ____________________________ Title: ____________________________ \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\ \text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\ \text { internal audit } & \text { Expected } & \text { Expectation } \\ \text { stardards. } & & & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\ \text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\ \text { are useful to } \\ \text { clients. } \end{array} & \begin{array} { l } \text { Performed Below } \\ \text { Expectation } \end{array} & \begin{array} { l } \text { Performed As } \\ \text { Expected } \end{array} & \begin{array} { l } \text { Perforned Above } \\ \text { Expectation } \end{array} \\ \hline \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\ \text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation } \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 5. Responds } & \begin{array}{l} \text { Performed Below } \\ \text { appropriately to } \\ \text { changing } \\ \text { conditions in the } \end{array} & \begin{array}{l} \text { Performed As } \\ \text { Expected } \end{array} & \begin{array}{l} \text { Performed Above } \\ \text { Expectation } \end{array} \\ \begin{array}{l} \text { department and the } \\ \text { medical center: } \end{array} & & \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\ \text { and reports to } \\ \text { clients in a } \\ \text { consultative } \end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\ \text { menaruer. } & & \text { Expected } & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\ \text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Evaluated by: _________________ Title: __________________ Date: ________________
Comments/Recommendations:
What is the name of this form? Name: ____________________________ Title: ____________________________ \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\ \text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\ \text { internal audit } & \text { Expected } & \text { Expectation } \\ \text { stardards. } & & & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\ \text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\ \text { are useful to } \\ \text { clients. } \end{array} & \begin{array} { l } \text { Performed Below } \\ \text { Expectation } \end{array} & \begin{array} { l } \text { Performed As } \\ \text { Expected } \end{array} & \begin{array} { l } \text { Perforned Above } \\ \text { Expectation } \end{array} \\ \hline \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\ \text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation } \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 5. Responds } & \begin{array}{l} \text { Performed Below } \\ \text { appropriately to } \\ \text { changing } \\ \text { conditions in the } \end{array} & \begin{array}{l} \text { Performed As } \\ \text { Expected } \end{array} & \begin{array}{l} \text { Performed Above } \\ \text { Expectation } \end{array} \\ \begin{array}{l} \text { department and the } \\ \text { medical center: } \end{array} & & \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\ \text { and reports to } \\ \text { clients in a } \\ \text { consultative } \end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\ \text { menaruer. } & & \text { Expected } & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\ \text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Evaluated by: _________________ Title: __________________ Date: ________________
Comments/Recommendations:
What is the name of this form? Name: ____________________________ Title: ____________________________ \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\ \text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\ \text { internal audit } & \text { Expected } & \text { Expectation } \\ \text { stardards. } & & & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\ \text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\ \text { are useful to } \\ \text { clients. } \end{array} & \begin{array} { l } \text { Performed Below } \\ \text { Expectation } \end{array} & \begin{array} { l } \text { Performed As } \\ \text { Expected } \end{array} & \begin{array} { l } \text { Perforned Above } \\ \text { Expectation } \end{array} \\ \hline \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\ \text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation } \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 5. Responds } & \begin{array}{l} \text { Performed Below } \\ \text { appropriately to } \\ \text { changing } \\ \text { conditions in the } \end{array} & \begin{array}{l} \text { Performed As } \\ \text { Expected } \end{array} & \begin{array}{l} \text { Performed Above } \\ \text { Expectation } \end{array} \\ \begin{array}{l} \text { department and the } \\ \text { medical center: } \end{array} & & \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\ \text { and reports to } \\ \text { clients in a } \\ \text { consultative } \end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\ \text { menaruer. } & & \text { Expected } & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\ \text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Evaluated by: _________________ Title: __________________ Date: ________________
Comments/Recommendations:
What is the name of this form? Name: ____________________________ Title: ____________________________ \begin{array} { | l | l | l | l | } \hline \text { 1. Erisures audits } \\ \text { are consistert with } & \text { Perfoned Below } & \text { Performed As } & \text { Perfaned Above Expectation } \\ \text { internal audit } & \text { Expected } & \text { Expectation } \\ \text { stardards. } & & & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 2. Erisures audits } & \text { Perforned Below } & \text { Performed As } & \text { Performed Above } \\ \text { are timely. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 3. Ensures audits } \\ \text { are useful to } \\ \text { clients. } \end{array} & \begin{array} { l } \text { Performed Below } \\ \text { Expectation } \end{array} & \begin{array} { l } \text { Performed As } \\ \text { Expected } \end{array} & \begin{array} { l } \text { Perforned Above } \\ \text { Expectation } \end{array} \\ \hline \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 4. Sets appropriate } & \text { Performed Below } & \text { Performed As } & \text { Performed Above } \\ \text { audit priorities. } & \text { Expectation } & \text { Expected } & \text { Expectation } \end{array} Comments/Recommendations: \begin{array}{l|l|l|l} \text { 5. Responds } & \begin{array}{l} \text { Performed Below } \\ \text { appropriately to } \\ \text { changing } \\ \text { conditions in the } \end{array} & \begin{array}{l} \text { Performed As } \\ \text { Expected } \end{array} & \begin{array}{l} \text { Performed Above } \\ \text { Expectation } \end{array} \\ \begin{array}{l} \text { department and the } \\ \text { medical center: } \end{array} & & \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \begin{array} { l } \text { 6. Interacts with } \\ \text { and reports to } \\ \text { clients in a } \\ \text { consultative } \end{array} & \text { Eerformed Below } & \text { Performed As } & \text { Performed Above Expected } \\ \text { menaruer. } & & \text { Expected } & \\ \hline \end{array} Comments/Recommendations: \begin{array} { | l | l | l | l | } \hline \text { 7. Nurtures hieh- } & \text { Perfarmed Below } & \text { Perfarned As } & \text { Perfonned Above } \\ \text { performing tearn. } & \text { Expectation } & \text { Expected } & \text { Expectation } \\ \hline \end{array} Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Comments/Recommendations: Evaluated by: _________________ Title: __________________ Date: ________________
Evaluated by: _________________ Title: __________________
Date: ________________

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