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Chirurgeon CIT Evaluation Form

Evaluator's Legal Name: Evaluator's SCA Name:
Evaluator's E-mail Address:
Event Name: Event Date:
Hosting Group: Chirurgeon In Charge:
CIT's Legal Name: CIT's SCA Name:
Number of events the CIT has worked (including this one):
Activities occurring while the CIT was on duty:
Armored Combat Rapier Combat Archery Thrown Weapons
Equestrian Feast Preparation Dancing Waterbearing
Summarize the Chirurgeon-in-Training's responses (including "band aid" requests):
   
Was this event's workload representative of a typical event? Yes   No
What is your opinion of the CIT's ability regarding... 5=Excellent 4=Good 3=Average 2=Fair 1=Poor
Attentiveness / Responsiveness 5 4 3 2 1 Not Evaluated
Presence of mind / Triage ability 5 4 3 2 1 Not Evaluated
Performance of First Aid skills 5 4 3 2 1 Not Evaluated
Knowledge of the limits of basic first aid 5 4 3 2 1 Not Evaluated
Communications skills 5 4 3 2 1 Not Evaluated
Ability to inspire confidence in patients 5 4 3 2 1 Not Evaluated
Knowledge of SCA combat and armor extraction 5 4 3 2 1 Not Evaluated
Knowledge of the responsibilities of a CIC 5 4 3 2 1 Not Evaluated
Knowledge of Kingdom Chirurgeon's policies 5 4 3 2 1 Not Evaluated
Judging by today's performance, would you recommend this CIT for a warrant? Yes   No
How many more events would you recommend this CIT work before warranting?
    0 1 2 3 4 5+ Would not recommend warranting
Additional Comments:
   
Include the email address of anyone besides yourself and the Kingdom Officer who should receive this report. An example might be your Seneschal or a Baronial Officer. Separate multiple addresses with a comma.
   
Security Code Security Code:    
Æthelmearc is a Kingdom in the Society for Creative Anachronism (SCA), a non-profit educational society dedicated to the recreation of the Middle Ages and Renaissance.

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