XXXXXXXXXXXX

COUNSELOR TESTER PERFORMANCE EVEALUTION

12/30/1899

NAME
XXXXXXXXXXXX
COUNSELOR TESTER PERFORMANCE EVEALUTION
TO
NAME
EXECUTIVE DIRECTOR

The (ORGANIZATION NAME) is an organization led by young people that aims to

provide mobile health services, sexual health education, mobile HIV/STI screening,
advocacy for human rights, capacity building, mental health support, research and
documentation, and the establishment of support groups. MHSR is dedicated to reaching
and assisting displaced and vulnerable populations, particularly youth who are at risk of
infection and disease, through their shelter and housing programs.

Our Vision

To create a world with equality for vulnerable person’s with improved access to health
care, human right and well-being.


Counselor Tester

NAME

DESIGNATION DATE OF UNIT

ENGAGEMENT

DATES ACTIVITY RESULT REMARK

SUPERVISORS REMARK

NAME UNIT PROGRAMS

COMMENT

SIGNATURE:
NAME
PROGRAM OFFICER
XXXXXXXXXXXX

APPROVAL

NAME UNIT DIRECTOR

COMMENT

SIGNATURE:
NAME
POSITION
XXXXXXXXXXX