Forms

Forms - Practicum

PRACTICUM FORMS

A. Practicum Orientation

Complete the online practicum orientation before starting your practicum learning contract.

B. Learning Contract Online Form and Instructions
  1. Submit your learning contract no later than one week before the regular registration deadline.  
  2. Click here for submission deadlines for the upcoming semesters.
  3. Click here to enter your learning contract in the online Practicum Management System.
  4. If you are off-campus, you will need to login via VPN to access the Practicum Management System.  VPN Instructions are found here: https://sph.uth.tmc.edu/content/uploads/2011/12/VPN_Instructions.pdf
  5. Draft and save your learning objectives and final product(s) description in a separate Word doc. Once these details are final, paste this information into the online learning contract form.  
  6. Be sure to enter your preceptor's name, organization, and e-mail address correctly. 
  7. Do not use an acronym for the organization's name.
  8. Submit your learning contract after completing all field accurately. Submitting an incomplete learning contract will delay the practicum office's approval.
  9. Your faculty mentor and preceptor will each receive an e-mail to approve your learning contract in this system.
  10. It is a good idea to follow up with your faculty mentor and preceptor to ensure that they have reviewed your learning contract.
  11. After your faculty mentor and preceptor have approved the contract, the practicum office will review and provide the final approval.
  12. Monitor your e-mail for potential changes to your learning contract.
  13. If you are an international student, print and bring a copy of your final, approved learning contract and the letter from your preceptor to John Adams in Student Affairs. (See the International Students tab on the Practicum homepage for Curricular Practice Training approval). 
  14. To make changes to your learning contract after it’s been approved, e-mail Practicum@uth.tmc.edu.
  15. Learning contract examples below.
    EXAMPLE_SPH Practica Learning Contract_General
    EXAMPLE_SPH Practica Learning Contract_DrPH
 C.  Travel Forms
  1. Please review the International Travel Guidelines tab on the Practicum homepage for instructions.
  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.  Practicum Opportunity Form 
  1. Complete sections I-III of this Practicum Opportunity Form if you are interested in hosting one of our practicum students and wish to have your organization and contact information posted on our practicum website.
  2. Complete I-IV of this form if you have a specific practicum opportunity that you would like us to post on our practicum website.
  3. E-mail the form to practicum@uth.tmc.edu .
F.  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.
G.  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.