1. Index of Appendices Description Due A B C D E F
Acknowledgement of Understanding
Complete and send a copy to:
Susan Rose (PMI Online Department)
Fax:
Due at the beginning of your clinical extern B
Clinical Education Competency Record
This is a list of procedures required by the ARRT. It is also used for you to document your competencies. Keep a copy of this in your binder. Once you’ve demonstrated competency in all required ARRT procedures, you will then send a copy of this to Susan.
Do not send until complete!
Due at the end of your extern C
Externship Timesheet
Complete and send to Susan as instructed on the timesheet.
Due every week D
Clinical Competency Evaluation Form & Criteria
Use this form to document your ARRT procedures. You will need to have your clinical instructor make copies of this form. As you complete your required procedures, send copies of this form to Susan, and keep copies for yourself in your binder. You must complete requires one of these forms for every ARRT procedure you complete. E
Technical and Professional Evaluation
This form will be utilized by your clinical instructor at the midpoint of your extern, and again at the end of your extern. Please provide your clinical instructor with a copy of this form.
Due at the midpoint and at the end of your extern F
Pregnancy Disclosure Form
Use this form to voluntarily declare pregnancy and notify the school of how you wish to proceed.
Due if you wish to declare pregnancy
Last updated 03/10/11