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CLINICAL SITE INFORMATION FORM (CSI)
developed by
APA Department of Physical Therapy Education
Why have a consistent Clinical Site Information Form?
The primary purpose of this form is for Physical
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How to fill out clinical site information form

How to fill out clinical site information form:
01
Start by gathering all the necessary information about the clinical site. This may include the site's name, address, contact information, and any specific requirements or certifications they may have.
02
Begin filling out the form by entering the basic details about the clinical site, such as its official name and location. Make sure to double-check the accuracy of this information before moving forward.
03
Next, provide any additional contact details for the clinical site, such as phone numbers or email addresses. This will allow the organization or department reviewing the form to get in touch if needed.
04
If there are any specific requirements or certifications that the clinical site must meet, ensure that you accurately document these on the form. This may include things like HIPAA compliance, insurance coverage, or specific training programs they offer.
05
Fill out any sections related to the specific program or department that the clinical site will be working with. This may include details about the type of patients or population served, any specialized equipment or facilities available, or any specific goals or outcomes expected from the clinical experience.
06
Provide any additional comments or notes that may be relevant to the clinical site's suitability for the program. This could include things like past experiences or collaborations, strengths or weaknesses of the site, or any other relevant information that may assist in the decision-making process.
07
Once you have completed all the required sections of the clinical site information form, review the form for any errors or missing information. Make sure that all fields are filled out accurately and that all necessary attachments or supporting documents are included.
08
Finally, submit the completed form to the appropriate individual or department as per the instructions provided. Keep a copy for your records in case any additional information or follow-up is needed.
Who needs clinical site information form?
01
Students or trainees: Individuals who are pursuing clinical placements or experiences as part of their educational or training program may need to fill out a clinical site information form. This form helps the program coordinators or administrators assess the suitability of a specific site for the student's learning objectives.
02
Program coordinators or administrators: These individuals are responsible for overseeing the placement or clinical experience process and ensuring that the selected sites meet the necessary requirements and standards. They would require the clinical site information form to collect relevant details and make informed decisions.
03
Clinical site supervisors or representatives: The individuals responsible for managing or overseeing the clinical experience at a particular site may need to provide information about the site's capabilities, requirements, and resources through the clinical site information form. This helps ensure that the site can meet the needs of the students or trainees and facilitate a successful learning experience.
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What is clinical site information form?
The clinical site information form is a document used to gather details about the location where clinical trials or studies will be conducted.
Who is required to file clinical site information form?
Principal investigators and sponsors are typically required to file the clinical site information form.
How to fill out clinical site information form?
The form should be completed with accurate and up-to-date information about the clinical site, including address, contact details, facilities, and capabilities.
What is the purpose of clinical site information form?
The purpose of the form is to provide essential information about the site where clinical research activities will take place.
What information must be reported on clinical site information form?
The form may require details such as site name, address, facilities, IRB approval, and contact information for the site coordinator.
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