NHS South West


Register as a mentor

To register as a mentor please complete the form below.

The register is open to any mentor who wishes to offer their services and applications are considered on an individual basis. We welcome mentors at all stages of their practice, whether you're highly experienced or simply exploring mentoring for the first time.

Your registration form acts as your mentoring profile and a mentee will use this information when selecting a mentor; applications should therefore include as much relevant information as possible. Profiles with photos often receive greater interest so please don't be shy and add a photo if you're comfortable to!

There are no specific requirements to become a mentor but effective mentors are:

  • Interested in their own development and learning as much as others
  • Good listeners
  • Self-aware, reflective and curious
  • Comfortable to challenge and encourage others to reflect on their own practice

To move between sections, click 'Next' or the required tab. When you have completed all sections, please click 'Submit my application now'.

nb. please do not use your browser's 'Back' and 'Forward' buttons, otherwise you may lose information that you have entered.

About you

Please tell us some details about yourself.

* denotes a required field

First name *
Last name *
E-mail address *
Organisation *
Organisation region *
Job title *
Telephone number *
Alternative telephone number
Work type *
Consent to storage and use of your personal data *

Mentor details

Please provide the following details specifically with regard to your mentor profile.

* denotes a required field

I have experience in and am willing to work with someone to help them *
I am willing to enter into a mentoring relationship that is *
I am willing to work within the following geographical area *
I would prefer my mentoring to take place via *
Number of mentoring relationships I am willing to have at any one time *

Mentee details

If you do not wish to register as a mentee, please click 'Next'.

Diversity & Inclusion

The following questions are for D&I monitoring purposes only, and the information provided will not be made available to other users:

* denotes a required field

Gender identity. Which of the following options best describes how you think of yourself?  *
Is your gender identity the same as the gender you were given at birth? *
Your age group *
How would you describe your ethnic origin? *
Your religion or belief *
Which of the following options best describes how you think of yourself? *
Do you consider yourself to be a disabled person as defined by the Equality Act 2010*
If you consider yourself to be a disabled person, and would like to, please indicate the nature of your disability (tick as many as are applicable)
Other disability - please specify

Mentoring agreement


CRBhub Coaching and Mentoring Hub is based on the CRBhub management system from CRB Associates