• 2021 MedQ Explore Reference Form

    Deadline: Midnight, Monday, March 8, 2021
  • The student is applying for the MedQ Explore program which will be held on an online platform this summer. Your candid assessment is important for this student’s competitive application. We need your feedback regarding this student’s ability to learn and participate in a structured online group setting, and to contribute in a respectful manner. Please note: One non-family reference is required for each student.  The student’s application to MedQ Explore will not be considered unless this completed reference form is submitted our office by the deadline of midnight on March 8, 2021.

  • Please rate the student in the following areas and provide comments:

    RATING SCALE: 1 = poor, 5 = excellent

  • Social Skills 


  • Motivation


  • Personality & Skills


  • Academic Ability/Interests

  • Thank you for supporting this student's career exploration efforts!  Please contact Eleanor Thomas, MedQ Explore Director,  at the contact information below if you have questions or additional feedback. 

    Email: ethomas@svtahec.org, Phone: 802-885-2126 x 103

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