Get Documentation Of Observation Hours Form - Www2 Cohpa Ucf

The Documentation Of Observation Hours Form is a crucial component for individuals seeking to document their physical therapy observation experience. This guide provides detailed steps to fill out the form accurately and efficiently, ensuring that your submission meets the necessary requirements.

Follow the steps to effectively complete the form.

1. Press the ‘Get Form’ button to retrieve the form and open it in an editable format.
2. Fill out the 'Applicant Name' field with your full name as it appears in your official documents.
3. Enter the 'Supervisor’s Name & Title' of the licensed physical therapist overseeing your observation hours.
4. Provide the 'Supervisor Phone Number' where the supervisor can be reached for verification purposes.
5. Complete the 'Facility Name' field with the name of the institution where you completed your observation hours.
6. Include the complete 'Facility Address' to ensure proper documentation.
7. Enter the 'Dates of Work/Volunteer Experience' in the specified fields, indicating the time period from start to end.
8. Specify your 'Applicant Position' by selecting from options such as observer, tech, or aide.
9. Fill in the 'Total Hours Worked' and 'Total Hours Observed' fields with the accurate numbers; note that only hours supervised by a licensed physical therapist will be considered.
10. Select the 'Type of Setting' from options such as inpatient hospital, outpatient, or school setting.
11. Identify the 'Primary Patient Population' relevant to your experience, choosing from adult, pediatrics, and other categories.
12. Provide a 'Brief description of applicant experience' summarizing your relevant background in fields like sports medicine or neurology.
13. Ensure the form is signed by the licensed physical therapist and include the date and license number.
14. Once all sections are completed, save changes, download, print, or share the form as necessary.

Complete your Documentation Of Observation Hours Form online today to ensure your submission is timely and accurate.