MIDDLE KINGDOM CHIRURGEONATE

Chirurgeon In Training (CIT) Evaluation

CIT’s Legal Name:	CIT’s SCA Name:
Event :	Location:
Chirurgeon in Charge:	Date of the event:
Number of events the CIT has worked (including this one:)

Check the activities occurring while the CIT was on duty:
Armored Combat	Rapier Combat	Archery	Thrown Weapons
Equestrian	Feast Preparation	Dancing	Waterbearing

Summarize the Chirurgeon-in-Training's responses (including "band aid" requests):

Was this event's workload representative of a typical event? Yes No

What is your opinion of the CIT’s ability regarding:	Excellent > Good > Average > Fair > Poor

Attentiveness / Responsiveness	5 4 3 2 1 Not Evaluated
Presence of mind / Triage ability	5 4 3 2 1 Not Evaluated
Performance of First Aid skills	5 4 3 2 1 Not Evaluated
Knowledge of the limits of basic first aid	5 4 3 2 1 Not Evaluated
Communications skills	5 4 3 2 1 Not Evaluated
Ability to inspire confidence in patients	5 4 3 2 1 Not Evaluated
Knowledge of SCA combat and armor extraction	5 4 3 2 1 Not Evaluated
Knowledge of the responsibilities of a CIC	5 4 3 2 1 Not Evaluated
Knowledge of Kingdom Chirurgeon's policies	5 4 3 2 1 Not Evaluated

Judging by today’s performance, would you recommend this CIT for a warrant? Y N

How many more events would you recommend this CIT work before warranting? 0 1 2 3 4 >=5 Would not recommend warranting

Additional comments:

Evaluator’s Legal Name:

Evaluator’s SCA Name:

Evaluator’s e-mail address: