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Acknowledgement of Supplemental Clinical Activity Policy Please initial after each of the following statements. I understand that supplemental clinical activities are voluntary and prohibited during
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How to fill out supplemental clinical activity request

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How to fill out supplemental clinical activity request

01
Obtain the supplemental clinical activity request form from the appropriate administrative office or website.
02
Fill out the required personal information, such as your name, contact information, and student ID number.
03
Specify the type of clinical activity you are requesting, including the location, dates, and hours involved.
04
Provide any supporting documentation or letters of recommendation if required.
05
Submit the completed form to the designated office for review and approval.

Who needs supplemental clinical activity request?

01
Students who are participating in clinical activities as part of their academic or professional training may need to fill out a supplemental clinical activity request.
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Supplemental clinical activity request is a form used to request approval for additional clinical activities outside of normal working hours.
Healthcare providers who wish to engage in extra clinical activities are required to file supplemental clinical activity request.
To fill out supplemental clinical activity request, healthcare providers must provide details of the additional clinical activities, dates, times, and reasons for the request.
The purpose of supplemental clinical activity request is to ensure that healthcare providers are properly compensated for additional clinical work and that patient care is not compromised.
Information such as the type of clinical activity, dates, times, reasons for the request, and any relevant patient information must be reported on supplemental clinical activity request.
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