OWIMS Mentoring Forms

The following forms are used to initiate your participation in the Program and during your relationship.  

Click on the forms to complete online or print the PDF to take to your meeting.  

Mentee Needs Assessment form (online version) (print version)
To be completed by the new Mentee (Female faculty at Instructor or Assistant Professor level)

Mentor Application form  (online version) (print version)
To be completed by any senior faculty wishing to be a Mentor (Female/Male faculty at Associate Professor or Professor level) 

Statement of Understanding form (online version) (print version)
Once the Mentee has selected her Mentor, this form is to be filled out together at their first meeting as a mentoring pair 

Mentoring Partnership Termination form (online version) (print version)
To be completed by each participant of a mentoring pair at the end of the relationship (both Mentee and Mentor complete this form separately) 

 

Quick Reference

OWIMS

336-713-4220

owims@wakehealth.edu

Hours
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Last Updated: 08-15-2014
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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.