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You are invited to participate in the Initial Mentorship Program Evaluation form. Your input is valuble and assists in improving the quality and effectiveness of the CYSS Mentorship program. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
How often do you meet with your mentor?
 
Weekly
 
Biweekly
 
Monthly
 
Never
 
Other
 
 
 
Is the time sufficient?
   
 
 
Are you benefitting from this partnership?
   
 
 
On a scale of 1-5 (1 - Very dissatisfied and 5 -VERY satisfied) how would you rate your mentoring experience?
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
 
 
How are communicating with your mentor/mentee?
 
email
 
one on one meetings
 
telephone
 
Other
 

 
 
What recommendatons or suggestions can you share that would help improve the mentoring program?
   
 
 
In what ways has your front line supervisor supported you while in the mentorship progam?
   
 
 
Is there any additional training that would make your partnership more successful?
 
conflict resolution
 
negotiating skills
 
communication
 
Other