College of Rehabilitation Sciences
Department of Physical Therapy
CLINICAL LEARNING CONTRACT
(Completed by the student in collaboration with the Clinical Instructor)
Student: Clinical Instructor:
Facility: Type of Placement: Date:
Objectives and Action Plan are to be filled out at the beginning of the clinical placement and reviewed during the clinical placement. Objectives should be listed
in point form. Comments can be made by the student and / or clinical instructor.
OBJECTIVES
ACTION PLAN/RESOURCES REQUIRED
COMMENTS
OBJECTIVES
ACTION PLAN/RESOURCES REQUIRED
COMMENTS