The Hutton Group, Inc.
1855 Bridgepointe Circle, Ste 23
Vero Beach, FL 32967
Phone (772) 770-1787
FAX (772) 365-7766

THE HUTTON GROUP

JOB OPPORTUNITIES

CANDIDATE RESOURCES


Formal Reference Form

Please fill out the following form as applicable. Thank you in advance for your cooperation.

(Please add the CANDIDATE'S Full Name in the box after "Reference for")

Date

Where were you when you worked with this person?

Years Known

Your Name

Title

Facility

Location

Telephone

Email Address

Relationship


If any of the following questions are not applicable, insert "NA"

Leadership/Management Style/Skills:


Clinical Skills or Knowledge Base:


Communication and Interpersonal Skills (written & verbal; with superiors, subordinates, peers)


Physician Relationships:


Staff Relationships:


Key Strengths:


Areas for Development:


Personal Problems Interfering with Performance/Attendance:


Reason for Leaving:


Would You Employ if You Had a Suitable Position:


Professional Appearance and Demeanor:


Additional Comments (that would help us form an accurate assessment of the candidate)