Faculty Member Name Rank Tenure Status Department College Personnel Number Needs Improvement for Rank Teaching Scholarly Activities APPR Relevant area(s) of concern for Date of the annual review Rating this plan (check all applicable) Unsatisfactory for Rank triggering this plan Service Patient Care Planned ongoing quarterly Final Assessment and assessments (month/year) Evaluation #3 #1 #2 month year Specific Performance, Results Activities, Resources &/or Metrics to Met or Description of Specific &/or Outcomes to be Achieved Actions to Accomplish Metrics to Assess Evaluate Not Met Performance Concern to Address Concern Outcomes (2) Ongoing Progress Achievement + Date 1. 2. 3. 4. Notes: (1) Add more rows if needed (2) Additional narrative should be included on an attached page (3) Attach APPR that triggered plan. Initial Plan Development Final Review of Plan Faculty Member Signature Date Faculty Member Signature Date Department Chair Signature Date Department Chair Signature Date Dean Signature Date Dean Signature Date
Faculty Member Name Rank Tenure Status Department College Personnel Number APPR Rating Needs Improvement for Rank Relevant area(s) of concern for this plan (check all applicable) Teaching Scholarly Activities Unsatisfactory for Rank Date of the annual review triggering this plan Service Patient Care Planned ongoing quarterly assessments (month/year) Final Assessment and Evaluation #1 #2 #3 month year Description of Specific Performance Concern Specific Performance, Results &/or Outcomes to be Achieved to Address Concern Activities, Resources &/or Actions to Accomplish Outcomes (2) Metrics to Assess Ongoing Progress Metrics to Evaluate Achievement Met or Not Met + Date 1. 2. 3. 4. Notes: (1) Add more rows if needed (2) Additional narrative should be included on an attached page (3) Attach APPR that triggered plan. Initial Plan Development Final Review of Plan Faculty Member Signature Date Faculty Member Signature Date Department Chair Signature Date Department Chair Signature Date Dean Signature Date Dean Signature Date
Form-9-Annual-Review-Improvement-Template.docx