Name of Facility/Service:
Educator's Name:
Please provide a brief outline of JCU's strengths in terms of clinical educator support:
Please provide a brief outline of perceived deficits in supports from JCU:
How can JCU assist to make improvements in placements:
(please select one)
Educator's Name: Date:
Clinical Educator Placement Feedback
Best time of day to phone?
(If applicable)
Please provide a brief outline of JCU STUDENTS'S strengths (e.g. areas of knowledge/ professionalism, placement
preparation):
Phone Number
Urgent
Not Urgent
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