Forms
In this section you will find a printable version of all logs and forms that you may need during your Family Medicine Clerkship and the online version of some others

Student Profile Form - [Online Version] (for completion before your Clerkship)

Common Problems Log - [Online version*] - [PDF version]

Common Procedures Log - [Online version*] - [PDF version]

Competency Assessment Log - [Online version*] - [PDF version]

Activities Checklist - [PDF version]

Student Mid-Block Self-Evaluation Form - [PDF version]

Student Final Evaluation Form - [PDF version]

Preceptor / Site Evaluation Forms - [Online version*] - [PDF version]

Excused Absence Form - [PDF version]

* Access through Blackboard

All the forms are in Adobe PDF format. You will need Adobe Reader to open these files. If you do not have Adobe Reader click on the Get Adobe Reader link below to install it in your computer.