CPE Reference Form

Dear Reference Provider,

We ask that you respond as candidly as possible. This reference will be kept strictly confidential. You can add an additional page to elaborate on any of your answers to the questions below. Please do not hesitate to contact us if you have any questions or if there is any further information that will help us better evaluate the learning needs of the applicant in her/his spiritual care educational process.

Please note: All fields are required.


Candidate Information

Reference Provider

2. How do you evaluate the candidate in:
6. Please evaluate the candidate on the follow scales:
Intellectual ability/General knowledge
Ability to handle conflict and stress
Job perseverance
Emotional maturity
Spiritual care effectiveness
Interpersonal communication