2022 NSBPA PA-C and PA-S Mentor Application
Survey for prospective mentors
Prefer not to say
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Hispanic or Latinx
Not Hispanic or Latinx
Where do you live? (City and state)
How old are you?
Prefer not to answer
How often would you like to interact with your mentee(s)?
Frequent (i.e., meetings approximately monthly)
Occasionally (i.e., quarterly)
As needed or casually (i.e., able to respond to email when mentees have questions or need advice)
What is your preferred method of contact with your mentee(s)?
Zoom/other virtual option
How many years have you been practicing?
N/A - PA student
What speciality do you practice in?
Do you agree with the NSBPA mission statement? If not, please explain. The mission statement can be found at
Would you be interested in presenting a Virtual Shadowing session for the NSBPA?
What questions or concerns do you have about being a mentor for the NSBPA? We will answer questions during our webinar informational session in September.
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