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CLINICAL MAKEUP TIME REQUEST FORM* School, College, University Name: ___ Instructor Name: ___ Course Title: ___ Number of Students (not to exceed 10): ___ MakeUp Date(s) Requested: ___ Times of Requested
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How to fill out clinical make-up time request

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How to fill out clinical make-up time request

01
Consult with your program coordinator or advisor to confirm eligibility for clinical make-up time
02
Fill out the clinical make-up time request form with your program coordinator or advisor
03
Include details of the missed clinical hours, reason for missing those hours, and proposed plan for making up the hours in the request form
04
Submit the completed form to the appropriate department or person for review and approval
05
Once the request is approved, follow the agreed upon plan to make up the missed clinical hours

Who needs clinical make-up time request?

01
Students in healthcare programs who have missed required clinical hours due to unforeseen circumstances
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Clinical make-up time request is a formal request submitted by a clinician to make up for missed clinical hours.
Clinicians who have missed clinical hours are required to file clinical make-up time requests.
To fill out a clinical make-up time request, clinicians need to provide details of the missed clinical hours and the proposed make-up schedule.
The purpose of clinical make-up time request is to ensure that clinicians meet the required number of clinical hours for their training or certification.
Clinical make-up time request must include information such as the reason for missing clinical hours, the number of hours to be made up, and the proposed schedule for make-up hours.
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