📝Academic/Professional Reference Form

The individual named below has applied for a position with BrightPath Neuro and has provided your details as an academic or professional referee. We would appreciate it if you could complete this reference form to help us assess their suitability for the role. Your responses will be treated in confidence and in accordance with data protection regulations.

👤Candidate Information

Candidate's Full Name

Role Applied For at BrightPath (if known)

👤Referee Information

Full Name

Job Title/Role

Institution / Organisation Name

Phone

Relationship to Candidate

(e.g. tutor, mentor)

Length of Time You Have Known the Candidate

🧾Candidate Overview

Please provide your perspective on the candidate’s skills, professional attributes, and potential suitability for the role.

In what context do/did you work with the candidate?

How would you describe the candidate’s engagement and reliability in their academic or professional activities?

Does the candidate demonstrate professionalism, empathy, and ethical awareness appropriate for a health, care, or education environment?

How would you describe the candidate’s ability to work independently and take initiative?

How well does the candidate work in group or team-based activities (if known)?

Would you recommend the candidate for a role in a professional setting such as BrightPath?

If you have any reservations or concerns, please explain

🗣️Additional Comments

Please include any other relevant feedback that may support the candidate’s application

✍️Declaration

I confirm that the information provided in this reference is accurate and complete to the best of my knowledge. I understand that this reference will be used for recruitment purposes by BrightPath and handled confidentially.

I Confirm

Signature

Clear

Date