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Mentor Report Form
This form is for any concerns, complaints, or feedback of your mentor. The report will be reviewed and depending on your answers, taken action to. Please answer each question honestly and to the best of your abilities.
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Name (First, Last)
Name (First, Last)
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Date
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How satisfied are you with the guidance and support from your mentor?
1 = Very Dissatisfied and 5 = Very Satisfied.
1 = Very Dissatisfied and 5 = Very Satisfied.
How satisfied are you with the guidance and support from your mentor?
1 = Very Dissatisfied and 5 = Very Satisfied.
1 = Very Dissatisfied and 5 = Very Satisfied.
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Rating
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Date
Time
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10
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Which of the following best describes your mentor?
Which of the following best describes your mentor?
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My mentor has poor communication (i.e., rarely sends out messages, responds in over 24 hours/ignores messages)
My mentor gives me haphazard advice
My mentor has issues marking with my commitments
Other:
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Please explain the situation in your own words
Please explain the situation in your own words
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If there are any additional comments on the behavior of other mentors, please write here.
If there are any additional comments on the behavior of other mentors, please write here.
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File upload
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Rating
Multiple choice grid
Checkbox grid
Date
Time
Answer key
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