Performance appraisal can be an emotionally charged experience for both the supervisor and the employee. The accuracy of the appraisal is dependent not only upon the evaluator, but also upon the appropriateness of the tool being used for the task. An employee's career advancement, professional development, monetary remuneration and self-esteem often may depend upon the final outcome of the process. A group of nurse practitioners practicing in a wide variety of clinical and administrative roles at the Johns Hopkins Hospital formed a task force to develop a performance appraisal tool that would adequately reflect the nurse practitioner role and that could be individualized according to the work setting. A general overview of the development process, the tool, its scoring system and instructions for implementation are presented.