16 17 Please note that you 18 must subtract your 19 meal break from the 20 total hours worked 21 column. 22 23 Hours per week 24 Nursing 37.5 25 Midwifery 3yr 35 26 Midwifery 78wk 37.5 27 Radiography 28 Physiotherapy 36 28 Occ Therapy 37.5 29 MSc Rehab 37.5 30 Dental 31 Student Signature Date ……………………………………………………………………………………. ……………………………………………………. Practice Mentor / Educator / Supervisor’s Signature Date ……………………………………………………. ……………………………………..................................................…………………............... The form should be signed by the student and countersigned by the Practice Mentor / Educator / Site Co-ordinator each month. In addition they will be checked by the Academic Mentor at the end of the tripartite meeting (nursing / midwifery) / at the end of the placement (OT) / at the final bipartite meeting (DR). ATTENDANCE SHEET PRE-REG NURSING, MIDWIFERY, RADIOGRAPHY, PHYSIOTHERAPY, OCCUPATIONAL THERAPY & DENTAL CERT HE Surname Forename ……………………………………………………………………………………… …………….………………………………………….. Cohort Month Year ……………. ……………… ……….……… Shifts worked with Total Clinician / Mentor mentor / Date Code Sign to Code Time Time supervisor? () Worked/ Verify Started Finished (for Nursing, Midwifery, Sick Dental Cert HE only) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Please note that you must subtract your meal break from the total hours worked column. Hours per week Nursing 37.5 Midwifery 3yr 35 Midwifery 78wk 37.5 Radiography 28 Physiotherapy 36 Occ Therapy 37.5 MSc Rehab 37.5 Dental 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Student Signature ……………………………………………………………………………………. Date ……………………………………………………. Practice Mentor / Educator / Supervisor’s Signature ……………………………………..................................................…………………............... Date ……………………………………………………. The form should be signed by the student and countersigned by the Practice Mentor / Educator / Site Co-ordinator each month. In addition they will be checked by the Academic Mentor at the end of the tripartite meeting (nursing / midwifery) / at the end of the placement (OT) / at the final bipartite meeting (DR). ATTENDANCE SHEET PRE-REG NURSING, MIDWIFERY, RADIOGRAPHY, PHYSIOTHERAPY, OCCUPATIONAL THERAPY & DENTAL CERT HE Surname ……………………………………………………………………………………… Forename …………….………………………………………….. Cohort ……………. Month ……………… Year ……….……… Date Shifts Total Worked/ Sick Code Clinician / Mentor Sign to Verify worked with mentor / supervisor? () (for Nursing, Midwifery, Dental Cert HE only) Code Time Started Time Finished 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15