Clinical Educator Forms

Clinical Site Information Form (CSIF)

Reservation Form 2010

The information from the Reservation Form is entered into a computer program from which students select their preferred clinical placements.  Note your facility has the option to use Method 1 indicating specific dates you will reserve for our students, or Method 2 indicating that you are willing to discuss student requests, but would not be obligated to any specific dates at this time, or a combination of Methods 1 and 2.

Forms for 2 and 3 week experiences

Student Performance Evaluation

Clinical Instructor's Evaluation of the SAU PT Program

Forms for 8 and 10 week internships

Student Objectives Form

PT CPI (Clinical Performance Instrument)

PT Student Evaluation of the Clinical Experience and Clinical Instruction

Weekly Planning Form

Clinical Instructor’s Evaluation of the SAU PT Program