This peer-assessment form was developed at SUNY Upstate Medical University for use in the context of longitudinal, case based small group learning. This form is intended for formative use and to drive student reflection. The RIME (reporter, interpreter, manager, educator) scheme (1) is the basis for course assessment. Only the R and I levels are available on the form as it is intended for use early in the MS1 year. More importantly, students should be trained in the purpose of form use and how to give quality feedback before completing the forms. Feedback is intended to be shared with peers to inform their growth and development. For use, please email: Lauren J. Germain, PhD. (germainl@upstate.edu)(1) DeWitt DE, Carline D , Paauw DS , Pangaro L, A Pilot Study of a "RIME" framework-based Tool for Giving Feedback in a Multi-specialty Longitudinal Clerkship, Medical Education, 42: 1205 -1209, 2008.