• Farmer Mentorship Study: Participant Intake Form

    Thank you for your interest in the Farmer Mentorship Study. This short intake form will help us determine eligibility and select a diverse group of participants for interviews. This form will take approximately 5-7 minutes. Your responses will be kept confidential and used only for research purposes. Completing this form does not guarantee selection for an interview.

  • Eligibility Screening

  • Are you currently or have you been involved in farmer mentorship or peer-to-peer support within the last 3 years?*
  • Are you 18 years of age or older?*
  • Are you located in Massachusetts?*

  • Mentorship Involvement

  • What is your role in mentorship?*
  • How long have you been involved in mentorship activities?*
  • What type of mentorship program are/were you engaged in?*
  • How often do/did you participate in mentorship interactions?*

  • Location in Massachusetts

  • Farming Context

  • What type(s) of farming do you engage in? (Select all that apply)*
  • How would you describe your farming stage?*

  • Demographics (Optional)

  • What is your gender?
  • What is your race or ethnicity? (Select all that apply)
  • Primary language(s) spoken

  • Follow-Up and Contact Info

  • Would you be interested in participating in a 60-minute interview?*
  • If yes, please provide your contact information.
  • Format: (000) 000-0000.
  • Preferred method of contact*
  • Should be Empty: