Forms - Practicum


A. Instructions

Review the step-by-step instructions for MPH and DrPH students on the practicum homepage.

B. Learning Contract Online Form 
  1. Click here to enter your learning contract in the online Practicum Management System.  
  2. If you are off-campus, you will need to login via VPN to access the Practicum Management System. VPN Instructions are found here:
  3. Click here for submission deadlines for the upcoming semesters.
 C.  Travel Forms
  1. Please review the Practicum Travel webpage for instructions on obtaining approval for your travel.
  2. Student International Travel for Practicum Application
  3. Travel Agenda Example 
  4. Office of Global Health Initiatives Application for Exemption from Travel Restrictions.  Note: You must be logged into the UTHealth intranet to complete this form.
  5. UTHealth Request for Travel Authorization: the practicum office will complete and e-mail this form to you after we've reviewed your travel.
 D.  Forms for International Students Enrolling in Practicum
  1. Please review the International Students tab of Practicum homepage for instructions.
  2. Curricular Practice Training Form
E.  Evaluation Forms
  1. The Office of Public Health Practice e-mails evaluations at the end of each semester. 
  2. Preceptor evaluation: assesses the student’s ability to accomplish the learning objectives and final product.  
  3. Student Evaluation: assesses the effectiveness of the practicum experience from the student’s perspective.
F.  Grade Change Form (for Faculty)      
  1. Log into the faculty myUTH portal. 
  2. In the Resources section, click on the Grade Change form.  
  3. This form can be accessed only by faculty from the myUTH portal.  We cannot post a direct link to this form.