6 / 2 0 1 0 14:3 < t FAX 9 0 1 4 4 8 8408 W UT NEUROSURGERY @001 ( f W October 8,2010 Delivered via Email Dr. Robertson, Your name has been provided as a professional reference for Christopher Duntsch, MD, who Is Inquiring about a career opportunity with Baylor Health Care System, Our employment decision on this physician is very dependent upon your accurate and honest assessment; therefore we ask that you carefully and fully complete the following reference fcrjn, Please return the form via email or facsimile to 972-860-8501. All responses are strictly confidential. (to) z e \ c {from) 1. How long have you known the physician?: 2. In what capacity have you known him/her (e.g. residency or fellowship program director; supervising attending physician; partner in practice)? t I X 3. WUt cUVvMfifJ' fa+re/uAtfftj Good Good __ .Average Below Average Good Average _ Below Average Howwould you rate his/her fund o f knowledge compared to the national peer group? V 7. Below Average How would you rate his/her fondo f knowledge compared to other residents/fellows in your program? Excellent. 6. Average How would you rate his/her clinical skills compared to national peer group? Excellent 5. ZV-TWdjfck How would you rate his/her clinical skills compared to other residents/fellows in your program? Excellent 4. atMi tExcellent Good Average , Bdow Average How would you rate his/her interpersonal skills inL dealing with peers, nursing personnel, and patients? Excellent Good y Average Ave V Below Average How would you rate his/her character and work ethic? Excellent Good _ Average Below Average •^ ,Good .Average Below Average 8a. Quality o f Service Excellent 8b, Judgment Excellent z V Good Average . Below Average J no ":34 FAX M1 MK MN: UT NEURDSURGERY (- Sc. Skill: 9. Ifynu an apening, yun hire this pummfl Lina,p1cm mm why, (iund Avurng: 13an Avengn 1| his/b9: drug and demeanor pmpor and pmfussionan '13 11. Men afsuungth 1. Minimllj ,wmw twat/If 15M 1. "Vina-x} f. slim cA//r1r<> I11: cmdxAnm'a willingness (n Hake call, Wonk ndAifinnalLlUms, am: elm: signed ii" maimm IF) um lay/um Thank you ngnin for your Inimnve. Plane fad fl'ea tn include addfiinmnl or can-mums on I legume than. Refaxcrwe for MD [@002 ^ " S ^010 11:32 9012876700 NEUROSCISNCK INST K #0091 P . 0 0 1 / 0 0 2 f > x ft October 8,2010 Delivered via Email Dr. Boop, Yourramc has been provided o r n. professional reference for Christopher Duntsch, Mil), who Is Inquiring about a career opportunity with Baylor Health Cure System. Our employment decision on this physlctot js very dependent upon your accurate and honest assessment; therefore we' ask tlwt yon carefully and fully complete the following reference form. Ploasa return the form via email or facsimile to ,972-860-8501., -Ml responses are strictly confidential, 1. How long huvo you known the physician?: (from) "2,Oc? ( 2. In what capacity have you known him/her (e,g, residency or fellowship program director; supervising attending physician; partner In practice)? &Krcy p r a><^ f J f a v i o i € c - T'o <2. 3. How would you rate his/her clinical skills compared to other residents/follows in your program? Excellent 4. • t^^Gocd Good Below Average Average Below Average How wouldj/uu rate his/hor fund o f knowledge compared to the national peer group? Good Average Bolow Average How would you rate his/her interpersonal skills In dealing with peers, nursing personnel, and patients? Excellent. 8, Average Good t-^Bxcellent 7. Below Average How would .you vote his/her flmdo f knowledge compared to other residents/fellows In yoiir program? //Excellent 6. Average p How would you rate his/her clinical skills.compared to national peev group? Excellent 5. (to) K"~~~Good Average Below Average Good . Average Below Average Good _Average _Bolow Average Good Average _Below Average How would you rate his/her character and work ethic? t^Excellont 8fl. Qilfllily-ef Service ^ Excellent 8b, Judgment Bxcellent. , ^ 11:32 annmaaov <