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This form is used by Indiana State University Doctor of Nursing Practice (Post-Master’s) students to verify their post-baccalaureate clinical and practicum hours as part of their admission and progression requirements.
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How to fill out post-baccalaureate clinical hour verification

01
Obtain the post-baccalaureate clinical hour verification form from your institution.
02
Review the requirements for clinical hours specific to your program or licensure.
03
Fill in your personal information at the top of the form, including your name and contact information.
04
List each clinical experience, including the name of the organization, supervisor, and dates of service.
05
Record the total hours completed for each clinical experience accurately.
06
Have your supervisor or clinical coordinator review and sign the form to verify the hours.
07
Submit the completed form to the appropriate office or department at your institution.

Who needs post-baccalaureate clinical hour verification?

01
Post-baccalaureate clinical hour verification is required for individuals applying for advanced practice programs, licensure in healthcare fields, or certain professional certifications.
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Post-baccalaureate clinical hour verification is a formal process that confirms and documents the clinical hours completed by an individual after obtaining their bachelor's degree, often required for further education or certification.
Individuals pursuing advanced degrees or professional certifications in healthcare or related fields are typically required to file post-baccalaureate clinical hour verification.
To fill out post-baccalaureate clinical hour verification, individuals must provide detailed information about their clinical experiences, including the setting, type of experience, dates of service, and total hours completed, often requiring signatures from supervising professionals.
The purpose of post-baccalaureate clinical hour verification is to ensure that candidates have met the necessary clinical practice requirements before advancing in their education or entering into professional practice.
The information that must be reported includes the name and contact information of the facility, dates of clinical practice, types of services provided, the number of hours completed, and signatures of verified supervisors.
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