Fullcirclehealing

		Mentor Interest Assessment The purpose of this questionnaire is to asses experienced parents' interest in joining the new mentor's program. The aim of the program is to pair current class members with a class participant who has gone through birth and at least the first three months of parenting, who will serve as a mentor. This can prove to be a very rewarding and valuable experience for both parties, and will assist the mentees in further developing their ideas regarding pregnancy, birth and parenting. Thank you for taking the time to fill out this questionnaire. Your Name: Your Email: Phone Number: I am a: My child is: old. Location of my child's birth (hospital, city, country): Please briefly describe your interest in being a mentor. How do you prefer to communicate with your mentee? Days and times most convenient for you: How much time would you be able to spend with a mentee? Please fill if you selected other in the above question: How many mentees do you wish to support in one month? From the following list, please check EACH category that interests you as a potential mentor. SUPPORT AREAS: Finding a compatible doctor Emotions of pregnancy Becoming a mother Becoming a father Creating a positive labor environment Supporting your wife in labor Supporting your wife postpartum Preparing for postpartum Breastfeeding Newborn care and common concerns Attachment parenting Postpartum communication / marriage health Postpartum depression Parenting in a foreign culture Premature birth Cesarean birth and recovery Children with disabilities Children with health concerns PROCESSES: Pain-Coping practices Your Deepest Question Taming Your Tigers Conflict Resolution / Communication with Doctor and Hospital Staff Healing Birth Trauma CONNECTIONS: Developing Connections, Creating Community Motherhood / Fatherhood ceremonies Community Resources For each checked box, please write a brief description of your experience, expertise and specific skills in that area: Write the numbers on the right: Full Circle Requirements for Mentors: If you choose to be a mentor in Full Circle Parent Mentoring Program it is expected that you will adhere to some basic guidelines. You are expected to meet/communicate with your mentee according to a schedule that you work out together. This should be a minimum of once per month for an hour unless otherwise agreed upon. Your role as a mentor is to provide support and guidance according to your mentee's needs. You are not responsible for finding or providing medical information or services. You will only assist the mentee in establishing their developmental goals (ie working through postpartum blues; coping with a premature baby; identifying and challenging fears surrounding birth, parenting, building a community in a foreign country, etc.) so that both of you know what is expected, and what the mentee aspires to gain through the mentoring relationship. In addition, please keep Full Circle apprised of your progress so that there can be some ongoing measure of the program's success. Finally, please be advised that this is a no-fault relationship and can be terminated at any time by either mentor or mentee. Thank you very much for volunteering to participate in the mentoring program. We hope this will prove to be a valuable and rewarding experience for all.


design & application :. fotovizyon