Sql Query Performance
Why are you using the condition?

CONVERT (DATE,e.CompletedDate) &gt;= '2018-11-01' 
AND CONVERT (DATE,e.CompletedDate) &lt; '2018-11-30'


This query is not SARGable, just rewrite your query as

e.CompletedDate &gt;= '2018-11-01' 
AND e.CompletedDate &lt; '2018-11-30'


And ensure you have an index with CompletedData field as the first field. As far as I see the condition, it should work in the same way but much faster and will use minimal resources.

As per your comment, apart from the proposed change in your WHERE condition you need to create a new index as:

CREATE INDEX IX_Examinations_CompletedDate ON Examinations(CompletedDate)