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CARDINAL HILL REHABILITATION HOSPITAL

PHYSICAL THERAPY

OPTIONAL STUDENT FORMS:

                      Learning Contract

                                                            OPT

 

The attached detailed clinical objectives reflect the results

 

of a discussion with                                   ,

 

Center Coordinator of Clinical Education/Clinical Instructor

 

at Cardinal Hill Rehabilitation Hospital, in which we

 

clarified expectations of my behavior or performance, in areas

 

that were identified as problems______________________________ ______________________________________________________________          

The purpose of defining specific performance statements is to

 

clarify the expectations of my performance during the

 

remainder of my clinical experience at Cardinal Hill

 

Rehabilitation Hospital.

 

I understand that I must incorporate these suggestions into my

 

daily activities at Cardinal Hill Rehabilitation Hospital. 

 

Failure to successfully meet these objectives by________________________ will result in____________________.               

(consequences: failure of the clinical experience, early

 

termination of the experience, etc).

 

 

I understand that emphasis on these objectives should in no

 

way be construed to mean that the remainder of the goals and

 

objectives for this experience are less important, or that

 

successful completion of the remaining objectives is not

 

required for successful completion of this experience.

 

                                                              Student's signature/date:____________________________________ 

CCCE/CI's signature/date:____________________________________ 

 

Revised:  June 1999,February 2004, August 2005

Reviewed: July 2000, December 2003


         



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