Job Evaluation Request Form

This form must be completed in order to submit your Job Evaluation Request as it is essential that all required information is submitted before the post can be considered by a panel.

Please ensure all documents are completed and signed by the relevant signatories. Incomplete submissions will not be processed and will be returned to the submitting Manager.

I would like to submit a request for a:*

Manager Name*

First Last

Email*

Organisation*

Job Title*

Title of post to be evaluated

Cover Sheet*

Please upload a completed Cover Sheet ensuring you have the required signatures included.

Max. file size: 20 MB.

If you do not have a Cover Sheet, please Please click Here to Download

Job Description*

Please upload the Job Description of the post, ensuring it includes all tracked changes made.

Max. file size: 20 MB.

Organisational Chart*

Please upload a current organisational chart that clearly demonstrates two levels higher and below as appropriate.

Max. file size: 20 MB.

Mental Effort

Concentration

Describe the duties that you undertake that require concentration. List the most important first.*

Give examples of activities or tasks, for example checking documents, carrying out calculations, operating machinery, taking minutes, carrying out therapy, carrying out intricate clinical interventions, driving etc

How many shifts during the week?*

Indicate the number of shifts per week - if less than weekly state frequency

How long for each shift?*

Indicate how long this activity would on average take and the lenght of your average shift e.g. 20 mins in a 7 hour shift

Mental Effort

Interruptions

If you are interrupted in the course of your work, describe the nature of the interruption and say whether you have to stop what you are doing to respond to the interruption and whether you have to re-prioritise your work as a result of it*

Give examples including what you were doing before the interruption and what you had to start doing as a result of the interruption

State how often this would happen*

Indicate how many times per shift and how many shifts per week

Job Evaluation Request

PHYSICAL EFFORT

Mental Effort

Mental Effort

Emotional Effort

Working Conditions

Are you required to use or be exposed to