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Mentor Weekly Report
Your Mentor Advisor:
Date of last meeting (mm/dd/yyyy):
Mentee's current location:
Probation (in the community)
Address Line 2:
How many hours did you spend with your mentee this week? (Include telephone calls email exchanges in-person visits):
1 hour or less
Would you consider this week's mentoring time your weekly average?
This week was average
This week was more than average
This week was less than average
Where did these meetings occur? (Check all that apply)
In Walker State Prison
At the mentee's home
At a restaurant or coffee house
Shopping at various merchant (groceries dry goods etc.)
Recreation center park hiking trail etc.
Accompanied mentee who was fulfilling his/her criminal justice obligation
Accompanied mentee running personal errands
In transit (my car)
What happened during your meetings this week? (Check all that apply)
Spoke in depth about serious issues
Recreated (athletics sporting events theater movie played games/cards etc.)
Met for a meal coffee snack
Attended church services
Helped navigate criminal justice system
What was the primary need(s) of your mentee at last meeting? (Check all that apply)
Someone to talk to
Medical / Dental / Mental Health and Treatment
Substance use and treatment
Crisis intervention (violence arrest emotional breakdown intoxication)
Employment / job hunting
Education and/or skills training
Relationship issues (friends family partner)
What topics have your explored with your mentee during this past week? (Check all that apply)
Nothing in particular just chit-chat
Criminal justice involvement
Self esteem issues
Problem solving / goal setting
Parenting and childcare
Healthy relationships (family friends)
Spirituality or religion
Housing needs or concerns
Medical health treatment
Dental health treatment
Mental health treatment
What resources did your mentee utilize to meet his/her needs during this week or since the most recent meeting? Include any resources/services that the mentee is utilizing on an ongoing basis? (Check all that apply)
Employment services including traiing programs
Specialized treatment providers (mental medical dental health)
Court mandated classes
Public transportation services
How would you characterize your mentee's emotional state at your last meeting? (Check all that apply)
How would you characterize your mentee's mental state at your last meeting? (Check all that apply)
Rationalizing poor decisions
Unable to focus
How would you characterize your mentee's physical state this week? (Check all that apply)
Appears physically healthy
Appears physically unhealthy
Not eating well
Have your worked on an Action Plan with your mentee? An Action Plan is always a work in progress. Submit first and final drafts.
No we have not yet worked on the Action Plan.
Yes first draft has been submitted.
Yes final draft has been submitted.
Yes we are implementing the Action Plan.
Comments about the Action Plan:
What has been the greatest challenge for you in working with your mentee during this past week?
Providing services (can't locate services or can't identify what is needed)
Mentee's attitude (resistant manipulative negative)
Mentee's progress (overwhelming issues self-destructive regressing)
Mentee is approaching challenges appropriately
Comments about these challenges:
When is your next meeting with your mentee scheduled? Mentors should meet with mentees 1-2 hours weekly at a consistent time. Always confirm the time and day of next meeting.
Is there a critical date coming up for your mentee in the next two months such as a court hearing graduation move divorce etc.?
If yes will you as a mentor be involved?
Please describe. Include event date location and significance:
Will you be out of town for a significant period of time soon?
If so dates:
Please explain your plan for supporting your mentee while you will be out of town.
How much time did you spend with your mentor advisor this week?
Less than 1 hour
During the last week has your mentor advisor met all your needs? Please describe.
Comments: Please make sure to comment if you did not receive the support you needed.
Would you like to remain working with this particular client?
I'd like to talk about it
Journal Entry: Any material anecdotes and assessments are particularly helpful.
Do not enter anything in this field:
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