Y1 Field/Elective Log
Student Name     
Date of Encounter 
Name of Facility  

Who was your supervising clinician/staff (last name, first initial)?

Describe the experience and evaluate its worth to you.
This experience was a good use of my time. Yes             No
I would recommend this experience for others. Yes             No
Was this a required clinical field experience or an elective experience? Required    Elective


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Page last updated Monday November 28, 2011

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