GENETIC PROFESSIONAL INTERVIEW FORM

Conduct a brief interview (in person, by phone, e-mail or other method) with a genetic professional who does work related to the applications of human genome technology or the ethical, legal, social or public policy issues of the Human Genome Project.

You may wish to use the Mentor Network for teachers and students.

Name of person being interviewed: ___________________________________________

Position/profession: _____________________________________________________

Association or involvement with Human Genome Project of person interviewed:



Which of the following topics did you discuss?

Information learned from expert:









Quotes of new information and facts learned:










Date & time of interview: _________________________________________________

_____ in person       _____ by telephone       _____ via internet       _____ other (describe):_____

Signature of individual being interviewed/ Consent to use quotes for course assignment
(may appear on the internet):

_____________________________________________________________________
If interview not conducted in person, written documentation in the form of a letter or e-mail message is sufficient.

Your Name: _______________________________________________________________

Your Profession: _____ Student

                          _____ Educator (level of your students) _______________________________

                          _____ Other (describe): ___________________________________________

Link that takes you to the Genetic Support Groups  Link that takes you to the Genetic Professional Home Page  Link that takes you to the Genetics Education Center Home

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Genetics Education Center
University of Kansas Medical Center © 1995-2008
Debra Collins, M.S. CGC, Genetic Counselor, dcollins@kumc.edu


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