Mentor Us Confidentiality and Commitment Form

Please review the Confidentiality and Commitment Form with your mentor/mentee before submitting the form together

Confidentiality:

All information shared during the mentoring relationship is confidential, with the exception of:

  • Knowledge of improper conduct
  • Concerns of unsafe behaviour or conduct that is unsafe or detrimental to the mentee, mentor, or University of Alberta
  • Conduct that violates the University of Alberta’s policies and code of conduct

Note:   If these types of issues are encountered, mentors or mentees should raise them with the Mentor Us Leadership Team and they will be followed up with the appropriate faculty member, so that they can be suitably addressed.

Commitment:

As mentoring partners, it is important that you have a shared understanding of the commitment you are both making to your mentoring relationship. Mentors and mentees should review and sign the following form with each other before starting the mentoring relationship.

A successful mentorship relationship will require you to:

  • Abide by any University of Alberta Policies and Code of Conduct (refer to       http://www.nursing.ualberta.ca/en/Graduate.aspx )
  • Commit to the relationship for one full academic year (September-April) Respect the confidential nature of all information discussed during mentoring meetings (as per confidentiality agreement) 
  • Complete every Mentor Us evaluation form for events and the year-end evaluation form
  • Report any problems to the Mentor Us program that you are not able to solve yourselves  
  • Recognize that this mentoring relationship is focused on building positive relationships and sharing information to the best of your abilities
  • Recognize that this is not a tutorial service  
  • Failure to comply with any of the above can lead to the termination of the mentoring relationship and individual participation by either the mentee or mentor
Name *
Name
I have read and reviewed the above information with my mentor/mentee and agree to comply with the above contract and understand what is expected of me as a member of Mentor Us. *
I have read and reviewed the above information with my mentor/mentee and agree to comply with the above contract and understand what is expected of me as a member of Mentor Us. *
Name
Name
I have read and reviewed the above information with my mentor/mentee and agree to comply with the above contract and understand what is expected of me as a member of Mentor Us.