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Evaluation Form

To better serve the Gaucher Community, it is important that we get the feedback of those who have personally been involved with the Gaucher Mentor Program. Please help us by giving us feedback about the Gaucher Mentor Program and the support and assistance you received from your mentor. All feedback is private and will be sent directly to the National Gaucher Foundation (NGF). The NGF will use your information as part of it’s informational and statistical reporting.

Gaucher Mentor Program

Please provide your mentor’s name:
How would you rate the support and assistance your received from your mentor:	Excellent Good Fair Poor
If poor, please explain:
Additional comments:

Was your mentor able to provide you with the information and resources you needed:	Yes No
Were you contacted by a mentor in a timely manner:	Yes No
Did your mentor stay in touch with your via email or phone until all of your concerns were addressed:	Yes No
Was your mentor able to address all of your questions and concerns, or provide you with contact information for others who could assist you?	Yes No
How would you rate the Gaucher Mentor Program overall:	Excellent Good Fair Poor
If poor, please explain:
Additional comments:
What recommendations would you make to improve the Gaucher Mentor Program?

Are you interested in becoming a Gaucher Mentor?	Yes No
If yes, have you read the qualifications and criterion for mentors and do you feel that you would be able and willing to carry out the duties of a mentor?	Yes No

If you are interested in becoming a Gaucher Mentor, have read the Mentor Program Information and agree with the Mentor Criterion, please click here to fill out the Mentor Application form which will be sent directly to the National Gaucher Foundation for consideration.

Thank you for your input and recommendations

Click her to "Submit" completed evaluation form