Get The Observation Hours Verification Form - Penn State Mont Alto

This guide provides step-by-step instructions for completing the Observation Hours Verification Form required for the Physical Therapist Assistant program at Penn State Mont Alto. Following these directions will help ensure your form is accurately filled out and submitted.

Follow the steps to complete the form efficiently.

1. Press the ‘Get Form’ button to access and open the Observation Hours Verification Form in your editing interface.
2. Begin by filling in the name of the individual who completed the observation in the designated field.
3. Next, input the name of the clinic where the observation took place in the provided area.
4. Fill in the address of the clinic in the dedicated section to ensure accurate location details.
5. Enter the date(s) of observation using the format mm/dd/yyyy, noting all relevant dates for your visit.
6. Document the total number of observation hours completed by entering the figure in the corresponding field.
7. Provide a brief statement detailing the type of physical therapy observed and any additional relevant information regarding your experience.
8. Ensure that the physical therapist or physical therapist assistant who supervised the observation signs the form, providing their printed name below their signature.
9. The applicant is required to sign the form, confirming the accuracy of the information presented.
10. Once all fields are completed, review the form for accuracy, then save any changes, and opt to download, print, or share the form as necessary.

Complete your Observation Hours Verification Form online today to ensure a smooth application process.