Get Clinical Field Experience Verification Form

Completing the Clinical Field Experience Verification Form online is an essential step for documenting your practical training. This guide provides clear instructions to help users efficiently fill out each section of the form, ensuring accurate and comprehensive submissions.

Follow the steps to complete the form seamlessly.

1. Press the ‘Get Form’ button to access the Clinical Field Experience Verification Form and open it in a suitable digital editor.
2. Begin by filling in the student information section. Enter your last name, first name, and student number accurately to ensure your records are correctly matched.
3. Proceed to the course information field where you will list your placement course, specifically entering the course code (e.g., TEC-591).
4. In the facility information section, provide the name of the facility you were placed in, the type of facility (e.g., Middle School), and select the appropriate state if applicable.
5. Indicate whether the facility is a Title One school by selecting the appropriate option.
6. Fill in the address details of the facility, including the unit number, city, and zip code for accurate identification.
7. Moving to the school information, specify the classification of the school (e.g., Public) and the school district to which it belongs.
8. In the practicum information section, describe the activities you completed during your practicum. Be specific about various tasks, using clear descriptions and breaking hours into specific categories.
9. Enter the date your practicum activities started and ended accurately to reflect your engagement period.
10. Review your entries for accuracy and completeness before proceeding to the agreement and signature section.
11. Sign the document digitally, ensuring your name is correctly input as per the provided example.
12. Once all steps are completed, save your changes, and choose to download, print, or share the completed form as needed.

Ensure your clinical field experience is well documented by filling out the form online today.