Clinical Evaluation Form

Please use the following link to access the Clinical Evaluation Form.  This link may be shared with your practitioner if s/he chooses to download the form independently.  This form may be emailed or mailed directly back to the HPS Committee (if the evaluator hopes for the responses to remain confidential), or given to the student to submit.  If an evaluator wishes for his/her responses to be kept confidential and has noted concerns/issues, the HPS Committee will work with the evaluator to provide appropriate feedback.  Generally, all feedback from evaluators will be shared unless the HPS Committee has been asked not to do so.

Clinical Evaluation Form

Clinical Evaluation Form - PDF Fillable