University of Arkansas at Little Rock

Psychology Department

 

End-Term Internship Mentor Feedback Form

 

Internship Mentor Name: _________________________________________

Internship Institution: __________________________________________

Intern Name: ______________________________________________

Date: ____________________

 

 

 

The intern I supervised

Strongly Agree

Agree

Not Sure

Disagree

Strongly Disagree

1.      

…was a benefit to my organization.

 

 

 

 

 

2.      

…was well prepared for this internship experience.

 

 

 

 

 

3.      

…was responsible (i.e. prompt for appointments).

 

 

 

 

 

4.      

…worked well with colleagues.

 

 

 

 

 

5.      

…worked well with clients/patients/customers.

 

 

 

 

 

6.      

…benefited from the internship experience.

 

 

 

 

 

 

 

 

Upon reflection

Strongly Agree

Agree

Not Sure

Disagree

Strongly Disagree

7.      

…I am looking forward to recruiting additional    UALR interns in the future.

 

 

 

 

 

8.      

… I enjoyed mentoring this intern.

 

 

 

 

 

9.      

…I realize I need an intern with different skill sets or interests than the current intern.

 

 

 

 

 

10.   

…I realize I need to be contacted by the internship coordinator to discuss some aspect of the current internship or future internships.

 

 

 

 

 

 

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