Verification of Observation Hours form - Abilene Christian University - acu 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in your personal information in the 'Applicant Information' section. Include your name, clinical facility name, address, city, state, and zip code.
3. In the 'Observation & Volunteer Activity' section, enter the dates you spent at the facility and total hours. Select all applicable types of settings from the provided options.
4. Provide a detailed description of your work and any comments in the designated area to give context to your observation experience.
5. Complete the 'Supervisor Information' section by entering the supervising Occupational Therapist's name, title, license number, email address, and phone number.
6. If you have additional hours from separate facilities, repeat steps 2-5 for each location as needed.
7. Once completed, save your document. You can submit it electronically via email or print it out for mailing.

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