Can I use an electronic signature?

Yes. Electronic signatures are legally valid in the United States under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and retention requirements are met.

Is notarization required for the form?

Generally no. Performance self-assessments are internal HR records and usually do not require notarization. If the form is used in a legal proceeding, consult counsel about authentication needs.

How long should HR keep completed forms?

Retain records at least three years to satisfy common federal guidance; extend retention for documents containing PHI (six years) or where state law requires longer periods.

What if the manager and employee disagree?

Document both perspectives in the form, include supporting evidence, and follow internal appeal or calibration processes to resolve rating discrepancies.

Can I change a submitted form?

Amendments should follow the organization’s revision policy. Maintain the original signed record and an addendum or replacement with a new signature to preserve auditability.

How do I ensure privacy for sensitive items?

Limit access using role-based permissions, redact unrelated personal data, and encrypt stored records. If PHI is present, handle under HIPAA with a BAA where applicable.

Electronic Signature
Templates
HR
Performance Self-Assessment and Feedback Form

Performance Self-Assessment and Feedback Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

PERFORMANCE SELF-ASSESSMENT AND FEEDBACK FORM

Personal Information

Full Name: Employee ID:

Address

Phone: Email:

Position Information

Job Title Department

Reporting Manager: Start Date: Current FTE/Status:

Self-Assessment: Key Responsibilities and Achievements

Briefly list your primary responsibilities for the review period:

Significant accomplishments and measurable results achieved during the review period:

Competencies and Self-Rating

For each competency, provide a self-rating on a scale of 1 (Needs Improvement) to 5 (Outstanding) and provide examples or evidence supporting your rating.

1. Communication — Rating 2. Teamwork & Collaboration — Rating 3. Problem Solving & Decision Making — Rating 4. Initiative & Productivity — Rating 5. Quality of Work — Rating

Goals and Development

Short-Term Goals (next 6 months) Long-Term Goals (6-24 months) Training or Support Needed

Employment History (most recent two employers)

Employer 1 — Company Name

Title: Dates Employed: From To

Responsibilities Reason for Leaving Employer 2 — Company Name

Title: Dates Employed: From To

Responsibilities Reason for Leaving

Education

Highest Degree Institution

Graduation Date:

References (Professional)

Reference 1 — Name

Phone: Email:

Relationship Reference 2 — Name

Phone: Email:

Relationship Reference 3 — Name

Phone: Email:

Relationship

Legal Disclosures and Certifications

At-Will Employment: I acknowledge and understand that my employment status is governed by the company's at-will employment policy, which permits termination of employment by either the employee or the employer at any time, with or without cause or notice, unless otherwise established in a written agreement signed by an authorized representative of the company.

Equal Opportunity: I acknowledge that the employer is an equal opportunity employer and does not unlawfully discriminate in employment matters on the basis of protected characteristics. I understand that job assignments, promotions, compensation, and other employment decisions are made on lawful, nondiscriminatory criteria.

Certification: I certify that the information contained in this form is true, accurate, and complete to the best of my knowledge. I understand that any false statements or material omissions may result in disciplinary action, up to and including termination of employment.

Authorization: By signing this form I authorize the employer to contact the references and previous employers listed herein and to conduct employment-related background checks as permitted by law. I understand that such checks may include verification of prior employment, education, and other job-related information.

Acknowledgment: I acknowledge that I have read and understand the statements above and consent to the authorizations specified.

Manager / Reviewer Feedback

Manager comments, performance observations, and recommended development actions:

Manager Overall Rating

Employee Certification

I certify that this self-assessment fairly represents my contributions, achievements and developmental needs during the review period. I understand that this document will become part of my personnel record.

Employee acknowledges the right to provide additional comments or dispute manager feedback in writing within the time frame established by company policy.

Employee Printed Name:

By (Employee Signature):

Date:

Reviewer Printed Name:

By (Reviewer Signature):

Date:

What the Performance Self-Assessment and Feedback Form Is

The Performance Self-Assessment and Feedback Form is a structured document employees use to record their accomplishments, challenges, goals, and development needs during a performance review cycle. It typically includes rating scales, narrative responses, examples of recent work, and space for goals or training requests. Human resources and managers use completed forms to inform discussions, development plans, promotions, and compensation decisions. When completed jointly with manager feedback and stored with personnel records, the form becomes part of an auditable employee file that supports performance decisions and compliance with internal policies.

Why a Clear Self-Assessment Improves Reviews

A concise self-assessment helps employees demonstrate contributions, clarifies expectations for managers, and creates a documented baseline for development conversations and HR actions.

Who Completes and Reviews This Form

Properly completed forms support fair evaluations, consistent records, and defensible HR decisions across the organization.

Employees preparing a self-evaluation of performance, goals, and training needs.
Managers who assess results, add feedback, and set development plans.
HR or People Operations teams that store records and use aggregated data.

Step-by-Step: Completing the Form

Follow this sequence to complete and submit a self-assessment correctly and efficiently.

01

Gather Records: Collect metrics, project notes, and examples from the review period.
02

Complete Self-Responses: Answer prompts clearly with measurable results and dates.
03

Attach Evidence: Upload supporting documents or links to work samples, if allowed.
04

Sign and Submit: Sign electronically or physically and send to your manager or HR.

Configuring the Online Form Workflow

Common online settings make routing and approvals consistent across teams.

Field	Configuration
Signature Field	Required for employee and manager
Date Field	Auto-fill on signing
Conditional Comments	Open when rating below threshold
Reviewer Order	Employee → Manager → HR

Technical Requirements for Digital Completion

Confirm the chosen platform provides retention, access controls, and encryption aligned with company policy and any industry regulatory requirements.

File Types: PDF and DOCX supported
Integrations: Works with HRIS and storage
Authentication: Email, SMS, or SSO options

Typical Submission and Routing Process

A standard digital flow reduces delays and preserves a timestamped audit trail for each stage.

Initiate: Employee starts the form online
Review: Manager receives and comments
Finalize: Both parties sign and date
Archive: HR stores signed record securely

Common Mistakes to Avoid

Incomplete examples: listing duties instead of measurable outcomes makes evaluations inconsistent and less actionable.
Incorrect dates or review periods: mismatches can cause disputes about which work is being evaluated and affect compensation decisions.
Missing signatures: unsigned or improperly signed forms may be rejected for official personnel files or audits.
Using informal language: unclear statements create ambiguity and can complicate performance improvement plans or disciplinary records.

Risks of Inaccurate or Missing Records

Employee Relations: Damaged trust or grievances

Legal Exposure: Potential discrimination claims

Compensation Errors: Incorrect raises or bonuses

Promotion Mistakes: Unjustified advancement decisions

Audit Gaps: Incomplete personnel files

Record Disposal: Failure to retain may hinder defense

Essential Security and Compliance Elements

Encryption: TLS 1.2/1.3 in transit

Data at Rest: AES-256 encryption

Audit Trail: Timestamped actions and IP

Legal Frameworks: ESIGN and UETA compliance

HIPAA: BAA required for PHI

Access Controls: Role-based permissions

Key Sections a Professional Form Should Include

A well-designed performance self-assessment combines objective measures with narrative context to produce a fair and useful record for employees and managers.

Overview

Clear instructions and the review period up front reduce confusion and ensure responses focus on the correct timeframe and expectations.

Rating Scale

A consistent numeric or descriptive scale with guidance on meaning helps calibrate manager and employee interpretations across teams.

Achievements

Space for measurable outcomes and quantified impact (metrics, dates, role) ensures claims are verifiable and useful for decision-making.

Development Goals

Specific, time-bound goals and training requests let managers plan support and link development to performance outcomes.

Manager Feedback

A dedicated section for manager observations, discrepancies, and areas for improvement creates a balanced record for HR review.

Signatures

Employee and manager signatures with dates and an audit trail confirm mutual receipt and acknowledgment of the review.

Vendor Pricing and Feature Comparison for eSignature

Compare starting prices and key capabilities for common eSignature vendors to evaluate cost and compliance for electronic performance self-assessments.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day trial	Varies by plan	Varies by plan	Varies by plan	Varies by plan
Bulk Send	Yes (Business Premium)	Yes (plan dependent)	Yes (plan dependent)	Yes (plan dependent)	Limited
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Realistic Use Cases for the Form

These two examples illustrate how organizations use a structured form to support performance and development conversations.

Retail Regional Office

A regional retail office standardized self-assessments across 120 staff to compare KPIs and training needs.

Implementation reduced review variance and improved promotion transparency across stores.
Managers used the combined self-assessment and manager feedback to identify candidates for leadership training and to document promotion decisions consistently.

Community Health Clinic

A mid-size clinic adopted digital self-assessments to capture clinician productivity and patient-care objectives.

The clinic combined ratings with training requests and compliance checklists.
Consolidated records helped HR prioritize continuing education and retained auditable files for accreditation reviews.

FAQs and Troubleshooting

Answers to frequent questions about completing, signing, routing, and retaining performance self-assessments.

Need help? Contact support

Can I use an electronic signature?
Yes. Electronic signatures are legally valid in the United States under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and retention requirements are met.
Is notarization required for the form?
Generally no. Performance self-assessments are internal HR records and usually do not require notarization. If the form is used in a legal proceeding, consult counsel about authentication needs.
How long should HR keep completed forms?
Retain records at least three years to satisfy common federal guidance; extend retention for documents containing PHI (six years) or where state law requires longer periods.
What if the manager and employee disagree?
Document both perspectives in the form, include supporting evidence, and follow internal appeal or calibration processes to resolve rating discrepancies.
Can I change a submitted form?
Amendments should follow the organization’s revision policy. Maintain the original signed record and an addendum or replacement with a new signature to preserve auditability.
How do I ensure privacy for sensitive items?
Limit access using role-based permissions, redact unrelated personal data, and encrypt stored records. If PHI is present, handle under HIPAA with a BAA where applicable.

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