KSU College of Veterinary Medicine
Mentor Evaluation of Student

Student's First Name
Student's Last Name
Practice or Agency Name
Mentor's Name
Email
Phone
Clinic Street Address
Clinic City
Clinic State
Clinic Zip Code
Type Of Practice
Dates Student Participated	to
Student's Performance Did your veterinary student through his/her attitude, personal conduct and appearance reflect credit upon the veterinary profession?
YesNo
Did you find your veterinary student eager and willing to learn all the phases of veterinary medicine?
YesNo

Rate the student in the following areas:
Basic Science Knowledge	ExcellentGood AverageFairPoorN/A
Patient Care	ExcellentGood AverageFairPoorN/A
Client Relationships	ExcellentGood AverageFairPoorN/A
Business Knowledge	ExcellentGood AverageFairPoorN/A
Professionalism	ExcellentGood AverageFairPoorN/A
Technical skills	ExcellentGood AverageFairPoorN/A
Animal handling	ExcellentGood AverageFairPoorN/A
Restraint	ExcellentGood AverageFairPoorN/A
Improvement in skills	ExcellentGood AverageFairPoorN/A

Comments

What was your general impression of the veterinary student's medical education to date?
SatisfactoryUnsatisfactory

Overall, how would you rate this student?
ExcellentGood AverageFairPoorN/A

General comments concerning mentorship programs, suggestions, etc.
The Kansas State University College of Veterinary Medicine appreciates your donation of time to help veterinary students gain experience and a better understanding of the veterinary profession. We can provide an Acknowledgement of Contribution certificate for this mentorship which has a place for you to declare the value of your contribution and potentially use it as a tax deduction. Yes, please send me an “Acknowledgement of Contribution” certificate.

Kansas State University College of Veterinary Medicine • Manhattan, KS • 66506 • 785-532-5660

Kansas State University

K-State

College of Veterinary Medicine