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Student attestation form 2026
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- Click ‘Get Form’ to open the student attestation form in the editor.
- Begin by entering your personal information. Fill in your name, phone number, email, and school in the designated fields.
- Indicate whether this is your first time at a ProMedica facility by checking the appropriate boxes for Core and Clinical modules. If applicable, submit a separate Error Prevention Certificate.
- For subsequent visits within the same academic year, check 'yes' as needed. If it’s not within the same year, mark the relevant Core and Clinical modules.
- Review the objectives listed to ensure you understand them. This section confirms that these topics have been covered in your curriculum.
- Sign and print your name at the bottom of the form, along with the date. Ensure you understand the confidentiality statement before signing.
- Once completed, print, sign, and return this form to your instructor or clinical preceptor prior to starting your learning experience at ProMedica.
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See more student attestation form versions
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2017 | 4.8 Satisfied (116 Votes) |
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