Design the Performance Appraisal Form – The Sign Off


The performance appraisal conversation between the manager and staff sometimes can be a period of struggle between both persons in terms of perceptions of the staff’s performance results. Sometimes the conversation can lead to disagreement, the conflicts and in some cases insubordination or overbearing.

Examples of Potential Conflict Situations

Here are examples of situations that would spark conflicts between manager and staff; and in due course sour the working relationship.

  • Situation1 – Staff thinks highly of his or her own performance results.
  • Situation 2 – The manager rated his favorite subordinate better.
  • Situation 3 – The manager refused to acknowledge the staff’s accomplishments or exaggerate the staff’s mistakes or failures.
  • Situation 4 – There were disciplinary actions in the period of performance review. It sparked and argument between both the manager or supervisor and employee.

Purposes of Sign Off Portion

The sign off portion of the performance appraisal should provide opportunity for the appraisee to:

  • Acknowledge that a face to face meeting between the manager or supervisor and the appraise has taken place.
  • Register his or her disagreement with the performance ratings given and the manager or supervisor’s comments.
  • Escalate his or her grievances.

What Are Already In Scoring Section

Let us assume that the following are already included in the Scoring Section of the performance appraisal form:

  • Supervisor’s overall rating.
  • Supervisor’s summary comments.
  • Supervisor’s signature.

Components of Sign Off Section

The sign off portion should contain the following sections:

  • Acknowledgement – I acknowledge that I have read this report and that I have been given an opportunity to discuss it with evaluator.
  • Employee Comments (Optional) – This section may be left blank or it may be used to comment in support or disagreement with appraisals and observations recorded on this form. Staff member may add an additional page if there is insufficient space for comments.
  • Escalation (Optional) – I would like to discuss this report with my reviewing officer – Yes/No
  • Instructions to Staff Member – Staff member sign and return the form to your supervisor within 48 hours of receipt
  • Reviewing Officer Acknowledgement – The signature of the rater’s supervisor indicates that he or she has read the completed performance appraisal. If requested, reviewing officer have discussed report with staff member on (date)
  • Cautionary Statement – The contents of the completed performance appraisal form are confidential. Please ensure that proper care is taken to protect the privacy of the staff member.
  • Distribution – On copy of this completed form will be kept by the appraiser, one by the appraisee, and the original copy in the employee’s personnel file.

You can refer to samples of performance appraisal forms mentioned in the references below.


John Hopkins University

Leap Academy Charter School Inc

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