Fieldwork Forms

Forms used by the UND OT department for level I and level II fieldwork are available below, including those completed by students during the fieldwork experience and by fieldwork educators in preparation for and evaluation of OT students.

Level I

OT 438: Practicum: Children & Adolescents Fieldwork Setting Fact Sheet

OT 462: Practicum: Physical Dysfunction Treatment Fieldwork Setting Fact Sheet

OT 463: Practicum: Psychosocial Treatment Fieldwork Setting Fact Sheet

Student Description of Level I Fieldwork

Level I Performance Report

Level II

Student Evaluation of Fieldwork Experience

Fieldwork Facility Evaluation

AOTA Fieldwork Data Form (updated 5/2015)

Sample of AOTA Fieldwork Performance Evaluation for the Occupational Therapy Student

OT Student Weekly Review Form