Please rate the following:
Check 1 for Poor, 10 for Excellent.

I. Evaluation of interest and aptitude for psychiatry:
1 2 3 4 5 6 7 8 9 10

II. Evaluation of ability to fit into our program:
1 2 3 4 5 6 7 8 9 10

III. Social skills and ease during interview:
1 2 3 4 5 6 7 8 9 10

Please describe any special problems or assets which should be noted:
  

Global Evaluation:
Acceptable Unacceptable