Behavioral Health Ambassador Recommendation Form

Thank you for completing this information on behalf of an applicant for the Behavioral Health Ambassador Program. Please be sure to answer all questions in their entirety. Thanks in advance and we are looking forward to reviewing your reference.

Name of Candidate*
First Last
Your Name*
First Last
Your Affiliation with the candidate*
Your business or university email address*
What is your professional title?*
Reference Questionnaire
In this section, you will be asked a total of three (3) questions about the candidate. Please be as candid as possible.
On a scale of 1 to 3, please rate the ability of the candidate to work well with others.*
- 1
- 2
- 3
1 being unlikely and 3 being likely
Considering the applicant's career trajectory, if you had a role within your institution in the Behavioral Health Field, would you hire this applicant? If yes, why? If no, why not? If unsure, why?*
Is there any additional information that you would like to share with us about the candidate?

Behavioral Health Ambassador Recommendation Form

Reference Questionnaire

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