NPG - Application to Become a Mentor/Mentee

First Name, Last Name

Phone

Practice/Affiliation

Title

Years of Experience in REI

Mentor

Mentee

 Clinical Operations/Management

 Third Party Management

 Clinical Skills in a REI Setting

 Empathy Fatigue

 Communication skills (Patients & Colleagues)

 Ethical and Legal Considerations

 Critical Thinking and Problem-solving

 Patient Education and Expectations

 Professional Development

 Onboarding to the field of REI

 Non-ART vs. ART

Other (please specify)

Yes