Tutor Appointment Report
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Student-Athlete Name
*
First Name
Last Name
Date of Appointment
*
-
Month
-
Day
Year
Date
Time of Appointment
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Course Name & Number
Student is fully utilizing course notes, textbook information, and peer support?
Yes
No
N/A
Student asked for explanation of material not understood?
Yes
No
N/A
Student responded positively to tutor's suggestions and instruction (or made a diligent effort to try)?
Yes
No
N/A
Student is aware of future class assignments and syllabus information?
Yes
No
N/A
Student shows a better understanding of the material since our last session?
Yes
No
N/A
Appointment Summary (PAT)
*
1
By checking this box, I confirm that I have not violated any applicable rules or regulations (University, NCAA, etc.) in providing services to this student.
Submit
Should be Empty: