Clinical field experience verification form 2025

1. Click ‘Get Form’ to open the clinical field experience verification form in the editor.
2. Begin by filling out the 'STUDENT INFORMATION' section. Enter your last name, first name, and student number accurately to ensure proper identification.
3. Proceed to the 'COURSE INFORMATION' section. Here, specify your placement course by entering the course code (e.g., TEC-591).
4. In the 'FACILITY INFORMATION' section, provide details about your placement facility. Include the facility name, type, setting, and address. Make sure to indicate if it is a Title One school.
5. Next, complete the 'SCHOOL INFORMATION' section by selecting the school classification and district accurately.
6. In the 'PRACTICUM INFORMATION' section, describe your activities in detail. List all tasks completed during your practicum along with total hours spent on each activity.
7. Finally, review all entered information for accuracy before signing in the 'AGREEMENT AND SIGNATURE' section. Ensure that you digitally sign and date the document.

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