Clinical observation checklist 2026

1. Click ‘Get Form’ to open the clinical observation checklist in the editor.
2. Begin by entering your name in the 'Student Name' field, followed by the 'Dates of Attendance' and 'Hours Completed' sections.
3. Fill in the 'Facility Name' and 'Facility Address' fields, ensuring to include city, state, and zip code for accurate identification.
4. Select the type of setting you observed by circling one of the options provided: Acute, Sub-Acute, Pediatric, Home Care, Outpatient Rehab Hospital, or Long-Term Care.
5. For each clinical behavior observed (Physical Appearance, Professional Behavior, Timeliness, Ability to Communicate), rate them on a scale from Excellent (1) to Poor (4) by selecting the appropriate number.
6. Use the 'Additional Comments' section to provide any further insights or observations that may be relevant.
7. Finally, ensure that the supervising therapist signs and dates the form before submission.

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