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Pat Capps Covey College of Allied Health Professions
Department of Occupational Therapy
Fieldwork - Forms
•  Profession
•  Faculty
•  Admission
•  Tuition/Fees/Residency
•  Core Performance Standards
•  Fieldwork
  •  Site Specific Objectives
  •  Self Assessments
  •  Entry-Level Competencies
  •  Remediation Ideas
    •  Clinical Reasoning
    •  Intervention
    •  Professional Behaviors
    •  Observation
    •  Grading Activities
    •  Therapeutic Handling
    •  Accepting Feedback
    •  Help When a Student is Failing
  •  Forms
  •  USA Curriculum
  •  Evidence Based Practice
  •  Performance Evaluation
  •  Student Projects
  •  Contact Fieldwork Supervisor
•  Pi Theta Epsilon
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•  Contact Us

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This section of the website helps you select useful forms to guide you in the process of supervision. There are several different ones for you to select from. Consider looking at each of them and then select the ones that would be most helpful in your setting.

Supervision Checklist Week 1 - This form contains a checklist for orientation activities and a box to write in experiences. It is very helpful for week one on fieldwork.

Supervision Checklist Weeks 2-12 - This form contains information about experiences provided to the student as well as feedback provided to the student. This is very useful to use weekly on fieldwork.

Weekly Feedback Form - This form allows you both to track the learning opportunities and experiences provided to the student each week as well as feedback on performance, judgment, and attitude.

Weekly Tracking Sheet

Learning Contract - This form is useful to help students understand their responsibilities and commitments to make changes to promote more success while on level II fieldwork. It includes objectives and timelines to have them participate in measuring their progress towards self-improvement.

Fieldwork Data Form

University of South Alabama Pat Capps Covey College of Allied Health Professions Department of Occupational Therapy