Please indicate the Placement for which you will be absent Date/s Placement description Coordinator/ Coordinator/ Absent Supervisor Name Supervisor Signature Make-up plan for missed learning discussed with Supervisor/Clinical Lecturer Yes No □ □ __________________________________________________________________________________ 4. Student Declaration I have provided supporting evidence to accompany my non-attendance (more than 3 days sick leave □ will require a medical certificate) Student Signature: Date: Office Use Only: Please indicate if leave puts students hours at risk Yes __________________ No □ □
Please indicate the Placement for which you will be absent Date/s Absent Placement description Coordinator/ Supervisor Name Coordinator/ Supervisor Signature Make-up plan for missed learning discussed with Supervisor/Clinical Lecturer □ Yes □ No __________________________________________________________________________________ 4. Student Declaration □ I have provided supporting evidence to accompany my non-attendance (more than 3 days sick leave will require a medical certificate) Student Signature: Date: Office Use Only: Please indicate if leave puts students hours at risk □ Yes __________________ □ No
clinical-placement-non-attendance.pdf.docx