LEVEL II FIELDWORK CHECKLIST
DATE
_________
Utilized The Successful Occupational Therapy Fieldwork Student
_________
Attended 1st fieldwork preparation meeting (beginning of semester prior to the
Level II placement)
_________
Turned in Personal Data Sheet
_________
Reviewed site information in site fieldwork file and online
_________
Carried out interview, if required by site
_________
Registered for OCTH 435 and 436 (BSMS) or OCTH 635 and 636 (MS)
_________
Visited Preceptor Education Program web page
_________
Wrote personal letter to fieldwork site approved by Academic Fieldwork
Administrator
_________
Sent letter to Fieldwork site at least 6 weeks prior to starting
________
Attended 2nd fieldwork preparation meeting to review Fieldwork Performance
Evaluation Form (FWPE) and process and to receive student packet with
shoulder patches, withdrawal deadlines, etc.
Have copy of:
________
Immunization and Hepatitis B titers
________
Current PPD results
________
Current CPR certification
________
Current health Insurance
________
Seasonal flu vaccine
________
Reviewed OSHA requirements for universal precautions and bloodborne
pathogens and HIPPA
________
Attended Fieldwork Educator’s Panel
________
Attended Fieldwork Farewell lunch end of semester to meet fieldwork faculty
FOLLOWING THE PLACEMENT:
________
Write Thank You note to the supervisor/site
________
Nominate exemplary supervisor and/or fieldwork site for MOTA award