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Click ‘Get Form’ to open the femostop checklist in the editor.
Begin by entering the Employee Name and Date at the top of the form. This information is essential for tracking and accountability.
In the Theory section, review each item carefully. For each component, ensure that you check off whether it has been observed or verbalized by the employee.
For items a through i, provide initials and dates in the appropriate columns as you assess each skill related to Femostop usage.
At the bottom of the page, have the preceptor sign their name and date to confirm completion of the checklist.
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