College of Health Professions : Clinical Education : Physical Therapy

Student Progress Final Evaluation Grade Report

The student demonstrates clinical performance that is at or approaching entry-level physical therapy practice. The Clinical Performance Instrument documenting the student's progress will be returned to MUSC after the completion of the clinical experience.

Student Attending Rotation

Student Name*

Label*

Start Date*

End Date*

Evaluation*

Facility Information

Facility Name*

Address*

City*

State*

Fax Number

Clinical Instructor Assigned to MUSC Student

Instructor Name:*

Instructor E-mail:*

Instructor Telephone:*

Additional Clinical Instructor Assigned to MUSC Student

Instructor Name (2)

Instructor Email (2)

Instructor Telephone (2)

Fields marked with * are required.

If you have any questions or concerns, please do not hesitate to contact Debbie Brown or Gretchen Seif. Thank you for participating in the education of our physical therapy students.

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Student Progress Final Evaluation Grade Report