Get Request To Modify Clinical Practicum Sequence In Communication ... - Govst

This guide provides clear instructions for filling out the Request to Modify Clinical Practicum Sequence in Communication Disorders. Following these steps will help ensure a smooth submission process and successful modification of your clinical practicum sequence.

Follow the steps to complete your modification request.

1. Click the ‘Get Form’ button to obtain the document and open it in your preferred online editor.
2. Print your name clearly where it states 'Student Name (please print):' and indicate the current date in the 'Date' field.
3. Sign the form in the 'Student Signature' area to affirm your request.
4. Indicate if you are requesting a modification to your clinical practicum sequence by marking the appropriate box.
5. If changing the first practicum in speech-language pathology (CDIS 853), provide your original starting date and revised starting date in the specified fields.
6. If you are requesting one or more terms off, list the term(s) in the provided space.
7. Describe the changes you are requesting, including details of your original and proposed clinical practicum sequences. Attach additional sheets as needed for clarity.
8. Submit the completed form with any attached documents to the relevant department for processing.
9. Once processed, you will receive the department's decision regarding your request. This may be indicated by a signature and date from the Department Chair and the Director of Clinical Education.
10. Finally, you can save changes, download, print, or share the completed form as needed.

Start completing your Request To Modify Clinical Practicum Sequence online today!