MENTOR EVALUATION

Mentor Evaluation

Step 1 of 5

20%

• Mentee's Name*
  First Last
• Mentee's Email*
• Mentor's Name*
  First Last
• Date*
  MM slash DD slash YYYY

• PROFESSIONALISM

• Professional Physical Appearance
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Overall Attitude
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Interaction with patients and family
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Interaction with other agencies
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Interaction with fellow team members
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Interaction with mentee
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Shift punctuality
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree

• PERFORMANCE

• Has good overall knowledge of company
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Actively listens to concerns and answers questions
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Provides clear and concise instruction
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Leads by example
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Provides constructive and appropriate feedback
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Communicated with me regularly
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Contacted me prior to my first shift
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Assisted with and/or demonstrated proper lifting techniques
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Assisted with and/or demonstrated proper stretcher operations
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Has adequate or above average medical knowledge
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Introduced me to team members
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Introduced me to members of management team and the Directors
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Introduced me to HR, Scheduling, and Finance
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• Provided in depth tour of building
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• My mentors behavior and attitude is an example of professionalism
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree

• OVERALL

• I felt welcomed by my Mentor
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• My Mentor demonstrated genuine interest and concern for my success
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• I felt welcomed by the Management team
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• I received adequate overall training
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree
• I would recommend my Mentor
  Select RatingStrongly AgreeAgreeDisagreeStrongly Disagree

• Please elaborate on any area’s in which you selected “Strongly Disagree” so that we may correct any issues or concerns.*
• Would you recommend your Mentor for training future new team members? Please elaborate on specific traits or examples to support your answer.*
• Comments
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