Get University Of The Sciences Physician Assistant Shadowing Patient Contact Hours Form 2021-2025

Filling out the Physician Assistant Shadowing Patient Contact Hours Form is an essential step for students applying to the University of the Sciences Graduate Physician Assistant Program. This guide provides a clear, step-by-step approach to ensure all components of the form are completed accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click 'Get Form' button to obtain the form and open it for editing.
2. Enter your last name, first name, and middle initial in the designated fields to identify yourself on the form.
3. Provide your student ID number to associate the form with your application.
4. Complete the section titled 'Practice or facility' by supplying the name of the healthcare facility where you completed your shadowing or patient contact hours.
5. Fill in the facility's address, including the city, state, and zip code, ensuring that all information is accurate for future references.
6. Include your supervisor’s full name and title to acknowledge the individual overseeing your shadowing experience.
7. Provide the supervisor's phone number for any necessary follow-up or verification.
8. Specify the type of shadowing or patient contact experience you had, providing clear details about the nature of your activities.
9. Enter the dates of your shadowing experience, indicating both the start and end dates to clearly define the length of time spent.
10. Calculate and record the total number of hours spent in shadowing or direct patient contact, ensuring this aligns with the program's requirements.
11. Evaluate your performance by having your supervisor rate you on various qualities, including professional attire, promptness, ability to follow instructions, and attitude and willingness to learn. Make sure they check the corresponding boxes.
12. Finally, obtain your supervisor's signature and the date to validate the form. This approval is necessary for the form to be considered complete.
13. After all sections are filled out accurately, save the changes. You may now download, print, or share the completed form as required.

Complete your documents online and ensure your application is ready for submission.