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Director of Clinical Education - Angela Binsfeld

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Please be aware that a felony charge may affect your ability to obtain fieldwork placements and/or sit for the board examination.

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Clinical Request Forms (PDF):

• Clinical Internship Request Form
• Clinical Internship Request Form (2 Week Session)
  January Clinical Orientation

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• Handbooks
• Course Syllabi
• Course Assessment Tools
• Contractual Documents
• Forms - Appendices
• Resources
• Universal Precautions
• Clinical Education Courses
• APTA Links

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***Selected links may require Adobe Acrobat***

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Handbooks (.pdf):

• Student Clinical Education Handbook

• Faculty Clinical Education Handbook

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Course Syllabi (.pdf):

• PTS 651 syllabus

• PTS 751 syllabus

• PTS 851 syllabus

• PTS 852 syllabus

• PTS 853 syllabus

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Course Assessment Tools (.pdf):

• PTS 651:  Introduction to Clinical Practice - Guide for Clinical Instructors

• PTS 651 Assessment Tool

• CPI (Version 2007)

• Professional Behaviors

• Professional Behaviors - Beginning

• Professional Behaviors - Intermediate

• Professional Behaviors - Entry Level

• Professional Behaviors - Post-Entry Level

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Contractual Documents (.pdf):

• Clinical Affiliation Agreement Template

• Program Memorandum

• Program Responsibilities Include:
  Student Background Check
  Verification of OSHA expectations
  

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Forms - Appendices (.pdf):

• Case Report Form

• Clinical Site Information Form (CSIF)

• Intern: Personal Data Form

• Intern: Self-Assessment Form

• Learning Objectives Form

• Patient Log

• Physical Examination Form

• Physical Therapist Student Evaluation: Clinical Experience and Clinical Instruction Form

• Site Visit Evaluation Form

• Student Action Plan / Program Planning Flowchart

• Student/Clinical Instructor Telephone Conference Form

• Survey of Patients' Diagnoses

• Weekly Planning Form

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Resources (.pdf):

• Domains of Learning

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Clinical Education Courses (.pdf):

• Advanced APTA Credentialed Clinical Instructor Program - September 12-13, 2013
  
        • Brochure
  
        • Dossier

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APTA (American Physical Therapy Association) Links:

• APTA Home

• Frequently Asked Questions about the Physical Therapist and Physical Therapist Assistant Clinical Performance Instruments.

• APTA Education Strategic Plan

• Commission on Accreditation in Physical Therapy Education (CAPTE)

• APTA Clinical Education

• Student Services and Medicare Reimbursement

• Professionalism in PT: Core Values

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University of Wisconsin-La Crosse
1725 State St. La Crosse, WI 54601
(608) 785-8000