MENTEE EVALUATION FORM

Ateneo School of Medicine and Public Health

Dear ASMPH Student,

You are kindly requested to fill in the evaluation form and return it along with your
Faculty and Module evaluations.

Thank you very much for your cooperation. The information you provide would help
us strengthen the program and to assess the effect of mentoring on our students.

Batch:  2012  2013  2014  2015

ID Number ______________________________________
Name of Mentor ______________________________________
Date ______________________________________

How often did you meet your mentees this year?

 5  4  3  2  1  not at all

If you missed some sessions, please state why

_______________________________________________

What is the average length of the mentoring session with each student?
 less than 30 min  30-45 min  45min-1 hr  more than
one hour

A. PROGRAM ASSESSMENT
Please use a scale of 1-5, with 1 as unsatisfactory and 5 as excellent)

What is your general assessment of the mentoring 1 2 3 4 5

program?
How satisfied were you with your mentor match? 1 2 3 4 5
Did you get sufficient orientation on the program? 1 2 3 4 5
Did you receive enough information about your 1 2 3 4 5
mentor?
Were you happy with the frequency of meetings? 1 2 3 4 5
Were you happy with the style of mentoring? 1 2 3 4 5

Comments/Suggestions on the Mentoring Program

 B. MENTORING RELATIONSHIP ASSESSMENT

What were one or two most beneficial developments you could identify in yourself
as a result of your relationship with your mentor?
1.
2.

What were one or two key issues or concerns that emerged for you in your sessions
this year?
1.
2.

In what ways did your mentor help you to discover or address these issues or
concerns?
1.
2.

What are one or two things you plan to do more with your mentor next year?
1.
2.

What do you intend to do less of, or change, as a result of the mentoring sessions?
1.
2.

What recommendations/comments do you have to make the mentoring more

effective?
1.
2.
3.

Thank you for your cooperation.

_______________________________
Your signature