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HUNTER COLLEGE DEPARTMENT OF PHYSICAL THERAPY PROGRAM
CLINICAL EXPERIENCE Formation I: to be filled out by applicant Name: ___
I do ___ do not ___ waive all rights to see or review the reference submitted
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How to fill out clinical experience form

How to fill out clinical experience form
01
Gather all necessary information such as school name, location, dates attended, hours completed, and supervisor's contact information.
02
Do research on the specific guidelines provided by the organization requesting the clinical experience form.
03
Fill out the form accurately and neatly, making sure to provide all required information.
04
Double check all entries for accuracy before submitting the form.
05
Submit the completed form to the designated person or organization within the specified deadline.
Who needs clinical experience form?
01
Students completing internships or clinical rotations in a healthcare setting.
02
Healthcare professionals seeking licensure or certification.
03
Medical school applicants requiring documentation of clinical experiences.
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What is clinical experience form?
The clinical experience form is a document used to report the practical experience gained by a healthcare professional during their training or practice.
Who is required to file clinical experience form?
All healthcare professionals who are completing a training program or maintaining their licensure may be required to file a clinical experience form.
How to fill out clinical experience form?
The clinical experience form typically requires the individual to provide details about their clinical placements, procedures performed, supervising physicians, and any relevant patient interaction.
What is the purpose of clinical experience form?
The purpose of the clinical experience form is to document and verify the practical experience of healthcare professionals for training, licensure, and credentialing purposes.
What information must be reported on clinical experience form?
The clinical experience form may require details such as the healthcare professional's name, training program or organization, dates of clinical rotations, procedures performed, and supervising physician information.
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