Clinical Facilitator : Week: Course Coordinator: 5 Course: Dates of Placement: Student Academic Student CF/ Student CF/ Student Clinical Progress leave days Liaison If progress unsatisfactory, please Student Name Placement leave days Meetings Phone calls challenge in satisfactory (total to contact provide brief details (this week) (number) (number) place Y/N Y/N date) required Y/N
Clinical Facilitator : Week: Course Coordinator: Course: 5 Dates of Placement: Student Name Placement Student leave days (this week) Student leave days (total to date) CF/ Student Meetings (number) CF/ Student Phone calls (number) Clinical challenge in place Y/N Progress satisfactory Y/N Academic Liaison contact required Y/N If progress unsatisfactory, please provide brief details
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