Pre-Mentoring Evaluation Form

Hand in Hand requires each mentor to submit a Pre-Mentoring Evaluation form for their newly assigned mentee. It is recommended that you ask these questions of your mentee at your initial visit. At the conclusion of your time with your mentee, we will ask that you submit the form once again.

Through this evaluation form, we are able to track progress made by the mentee and provide supportive evidence to our funding sources that Hand in Hand is accomplishing its objectives and mission.

We appreciate your willingness to assist us in this effort.

Name of Mentor

First Last

Name of Assigned Mentee

First Last

Assessment Date

Single or Married

How many children?

What are the biggest challenges you are facing?

May check more than one box

Finding housing

Finding employment

Getting an education or learning a skill set

Overcoming mental illness/challenges

Keeping children safe

Getting custody of children

Learning how to be a better parent

Contention in the home

Suffering serious health challenges

Ask the mentee the following questions. Assign a numerical value in questions 1 through 7, 1= STRONGLY DISAGREE, 10=STRONGLY AGREE

1. I am struggling to find or maintain secure housing

2. I am struggling to secure a job

3. I am struggling to provide financially for myself of my children

4. I am struggling to take care of myself

5. I feel lonely and isolated

6. I am struggling to feel connected to people in my community?

7. I am struggling to meet the emotional or physical needs of my children