Survey - Equipment Loan Program Volunteer Reference Check - The ALS Association Massachusetts Chapter

*1.	Question - Required - Your Name:
*2.	Question - Required - Name of person for whom you are completing this reference check:
*3.	Question - Required - How long have you known the applicant and in what capacity/relationship?
*4.	Question - Required - How is the applicant's ability to keep scheduled appointments? Excellent Good Fair Poor Unknown
*5.	Question - Required - How is the applicant's ability to follow policies and procedures? Excellent Good Fair Poor Unknown
*6.	Question - Required - How are the applicant's communication skills? Excellent Good Fair Poor Unknown
*7.	Question - Required - How well does the applicant handle feedback and constructive criticism? Very Well Well Fairly Well Poorly Unknown
8.	Question - Not Required - Is there anything else you'd like to share?