Wellness Warriors Mid-Program Check-In: Mentees

Wellness Warriors - Mid-Program Check-In: Mentees

Caseworker's Name(Required)

First Last

School/Site Name(Required)

Date(Required)

ACTIVITIES

What is your favourite activity so far?(Required)

What is your least favourite activity so far?(Required)

CONSISTENCY

Have you missed any sessions? Why?(Required)

Have your Mentors missed any sessions? Why?(Required)

CONNECTEDNESS

What do you tell others (parents, family, or friends) about the program, if anything?

Are your Mentor(s) easy to talk to?(Required)

Probe - Do you feel comfortable with them? Do you feel you could talk to them if something was bothering you?

Do you feel comfortable participating in group discussions and activities?(Required)

Have you ever felt unsafe, uncomfortable, or embarrassed in the program? Please explain.

Youth-Centredness

Describe how the program is going.(Required)

Probe - On a scale of 1 to 10 (1 meaning “I want the program to end” and 10 meaning that “it is awesome”) how do you feel? Why? What might make it a 10 out of 10?

Do you feel important and included in the group? Can you give me an example?(Required)

Alternative Question - Do you feel listened to and heard by the Mentors and the rest of the group? Can you give me an example?

STRUCTURE

Have you ever felt unsafe, uncomfortable, or embarrassed in the program? Please explain.(Required)

Have you seen your Mentor(s) outside of the program? Is so, why?(Required)

DURATION & EXPECTATIONS

Who would you talk to if you had questions or concerns about the program?(Required)

Do you want to continue attending the program?(Required)

If there is one thing you would like to change about the program, what would that be?(Required)

This field is for validation purposes and should be left unchanged.