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Dental Assistant Reference Check Template

This reference check form collects information about a job candidate from a previous employer or reference. It asks about the candidate's dates of employment, effectiveness, technical skills, supervisory skills, interactions with others, reason for leaving, and whether the reference would rehire the candidate. The form is used by the Talent Acquisition section of the Human Capital department to evaluate candidates during the hiring process.

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Aditya Adi Singh
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73 views2 pages

Dental Assistant Reference Check Template

This reference check form collects information about a job candidate from a previous employer or reference. It asks about the candidate's dates of employment, effectiveness, technical skills, supervisory skills, interactions with others, reason for leaving, and whether the reference would rehire the candidate. The form is used by the Talent Acquisition section of the Human Capital department to evaluate candidates during the hiring process.

Uploaded by

Aditya Adi Singh
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

REFERENCE CHECK FORM – EVALUATION

Talent Acquisition Section

CANDIDATE NAME

APPLIED POSITON

REFERENCE PERSON DETAILS


Reference Name
How long has it been since you last spoke with the YES NO
applicant? (Are you aware he/she had put you down as a
referee for this application?
What were the dates of his/her employment with you? Year From: DD/MM/YYYY
Year To: DD/MM/YYYY

CANDIDATE DETAILS
EFFECTIVENESS IN ROLE
What was the nature and length of your relationship with
the candidate?
How effective was the candidate in the performance of Outstanding
Exceed Expectation
his/her role? Meets Expectations
Need Improvement
Unsatisfactory
Not Applicable

TECHNICAL COMPETENCES

How would you describe the candidate’s level of technical


skills and knowledge?

SUPERVISORY SKILL & STYLE


Did the candidate supervise anyone in this position? YES if yes how many are they?_____
NO

If YES, “Can you describe the candidate supervisory skills


and style?” (NOT APPLICABLE)

INTERACTION WITH ALL LEVELS OF MANAGEMENT & STAFF

How did/does the candidate interact with different levels


of management and other employees in the department?

Page 1 of 2
HUMAN CAPITAL DEPARTMENT
REFERENCE CHECK FORM – EVALUATION
Talent Acquisition Section

REASON OF LEAVING
Why did the candidate’s leave the organization he was
working for?
REHIRE

Would you hire or want to work with this individual again? YES NO

OTHER
Are there any other comments you would like to add?
REFFERANCE SINGUTRE
Employee Name
Designation Date

Signature
Date

FOR ONLY OFFICIAL USE


HUMAN CAPITAL EMPLOYEE DETAILS
Employee Name
Position

Signature
Date
HUMAN CAPITAL EMPLOYEE - AGENCY
Employee Name
Position

Signature
Date

Page 2 of 2
HUMAN CAPITAL DEPARTMENT

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