Cultural Reflections Questionnaire

Please complete no later than Wednesday of Week 2, in preparation for “What your ESS Specialist Can Do for
You.” Please take a picture and send a copy to your ESS Specialist once completed. 25 (total) Loyalty Points
may be available for thorough completion of entire document.
Name:
1. What is something you are looking forward to doing in the United States?

2. Describe one nursing related reason you wanted to come to the U.S.

3. Describe one non-nursing related reason you wanted to come to the U.S.

4. What do you like to do to de-stress (think hobbies, talents) outside of work?

5. What is your favorite food?

6. What is a tradition from home you are excited to share with your new circle of friends and co-workers?

7. Describe three fun facts about yourself.

8. What do you like best about being a nurse (or therapist)?

9. How are you currently feeling about and handling the Cultural Program?

10. Describe something you’ve learned since arriving in the U.S.