Mentor's Evaluation of Mentee
For Mentors to complete at the end of the Mentor/Mentee relationship

Thank you for being a Mentor! You are a huge part of the PALS community, and we appreciate you!
Sign in to Google to save your progress. Learn more
Your Name *
Your Mentee's Name *
Date of the Mentored Birth *
MM
/
DD
/
YYYY
Was the assigned doula a good match for you? Briefly describe the initial contact. *
Did you discuss their doula training and prior birth experiences? *
Did you meet in person during this process? *
Was the communication adequate? Did the mentee contact you prior to the birth? During the birth? After? At other times? *
What was your most valuable contribution to this doula's experience? How were you able to facilitate their growth as a doula? *
How were you able to help the doula meet the challenges presented by this birth experience? *
Would you consider your mentee to be teachable, ready to listen and to learn? *
Are there further skills or concepts that need to be learned before this doula can be certified? *
Do you have any concerns about the doula's ability to serve clients according to PALS' Standards of Practice and Code of Ethics? *
If yes, please describe:
Is there any area that the Certification Committee needs to clarify with this doula?
Please evaluation the doula's answers on their self-reflection and explain why you agree or disagree.
Would you suggest a follow-up from another PALS member to help this doula connect with our community?
Does this doula have any interest in sharing their time or talents with PALS?
Will you continue contact with this doula? If not, did you discuss closure of the mentorship relationship?
Did you enjoy this mentorship experience? What would you change about this process, if anything? How can the PALS Mentorship Lead contribute to your satisfaction with this program?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms