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REQUIRED FORMS 2007-08

Community Health Practice Experience (Internship)

and Master of Science in Public Health (MSPH) Research Project

Please Note : These forms are for students in the MPH or MSPH programs
who began their studies in Summer 2006 and after.
(All other students, use forms on this page.)


Practice experience paperwork should be returned to Catherine Nolan, MPH Practice Experience Coordinator, for students' files.
Students should also give a copy of their paperwork to their Practice Experience Advisor.
Email to nolanca@slu.edu or bring to Salus Room 482. Thanks.

Community Health Practice Experience Required Forms

1
 Student Checklist (PDF) (Word)
2 Student Self-Evaluation of Experience/Competence (PDF) (Word)
3 Practice Experience Agreement and Learning Plan (PDF) (Word)
4
Practice Experience Timeline:
5

Guided Progress Report (PDF) (Word)

    • Example of Guided Progress Report (PDF) (Word)
6
Preceptor Final Practice Experience Evaluation (PDF) (Word)
7
Practice Experince Final Poster (template) (PPT)
    • Example of Practice Experience Poster (submitted as one PowerPoint slide) (PDF) (PPT)
    • Practice Experience Guidelines for Final Poster
      (PDF) (Word)

IRB / HIPAA On-Line Training

CITI (Collaborative Institutional
Training Initiative)

https://www.citiprogram.org/default.asp

Register as a new user and proceed with training at your own pace.  Training should be completed before beginning practice experience.

 

HIPAA Information

Practice Experience Supporting Forms (please review)

    • Competencies for the Practice Experience (PDF) (Word)
    • Practice Experience Syllabus  (PDF) (Word)
    • Practice Experience Faculty Advisors (PDF) (Word)
    • Guide for Student Interview of Potential Preceptor (PDF) (Word)
    • Preceptor Expectations Guide (PDF) (Word)

Master of Science in Public Health (MSPH)

Reseach Project

  • Guidelines for MSPH Research Project
    (PDF) (Word)
  • MSPH Research Project Description
    (PDF) (Word)

*   View PowerPoint: Completing Practice Experience Paperwork

*  View PowerPoint: Orientation to the Practice Experience