NFN Brain Connections Reference Check

Students Name

First NameLast Name

Your Name

First NameLast Name

Relationship to student:

Please rate the applicant on the following qualities based on your professional experience with them. Use the scale:
1 = Strongly Disagree
2 = Disagree
3 = Neutral
4 = Agree
5 = Strongly Agree

1. Professionalism: This candidate demonstrates professionalism and maturity in their communication and behavior.

2. Reliability: The candidate is reliable and follows through on tasks and responsibilities.

3. Collaboration & Interpersonal Skills: The candidate builds positive relationships with clients, patients, or team members.

4. Empathy & Sensitivity: This individual shows empathy and sensitivity when working with people who are experiencing emotional or cognitive challenges.

5. Receptiveness to Feedback: The candidate handles feedback well and shows a willingness to learn and grow.

6. Emotional Regulation: This person stays calm and composed under pressure or in emotionally intense situations.

7. Initiative: The candidate shows initiative and takes ownership of their work without needing constant direction.

8. Judgment & Boundaries: This individual maintains appropriate boundaries and demonstrates good judgment in a healthcare or client-facing setting.

9. Organizational Skills: The candidate has strong organizational skills and is effective at managing their time.

10. Team Fit: This person would be a valuable and positive addition to a mission-driven, collaborative team like NFN Brain Connections.

Please identify 2–3 strengths you’ve observed in this applicant:

Please identify 2–3 areas of growth in the applicant:

How likely are you to recommend this student for neurocognitive testing?(Please select one below)

Highly recommendRecommend without reservationRecommend with some reservationsDo not recommend at this time