Get Phs 7047

Filling out the Phs 7047 form is an important step for documenting clinical practice hours completed at accredited health care facilities or during deployments. This guide provides clear and user-friendly instructions to help you navigate the online form efficiently.

Follow the steps to successfully complete the Phs 7047 form.

1. Press the ‘Get Form’ button to access the Phs 7047 form and open it in the online editor.
2. Complete the identification section by entering your grade or rank, name (last, first, middle initial), organization, and contact numbers including duty phone and mobile number. Ensure your PHS serial number and email address are correctly filled in, along with your specialty and category.
3. Provide the total number of clinical hours completed along with the start and end dates of your clinical practice hours. Fill in these dates accurately to reflect your practice period.
4. Document clinical practice details by completing a separate section for each facility or deployment where you completed hours. Include the city/state location, name of the health care facility, and the specific dates of clinical practice.
5. For each line in this section, enter the number of clinical hours completed, the name and signature of your clinical supervisor, and the date. Additionally, provide a brief description of the clinical care rendered.
6. In the certification section, read the requirements stated in CCI 241.01 and CCI 633.01. Certify your understanding by entering your printed name, signature, date, and details about your supervisor.
7. Review all filled fields to ensure accuracy. Make any necessary corrections before proceeding to save or submit the form.
8. After completing the form, you can save your changes, download, print, or share the filled form as needed.

Complete your Phs 7047 form online today to ensure your clinical practice hours are accurately documented.