Practicum Site Supervisor Survey
Please provide your feedback regarding your experience supervising a practicum student. Your input helps us improve the practicum program.
Supervisor Name
*
First Name
Last Name
Supervisor Email Address
*
example@example.com
Practicum Site/Organization Name
*
Student Name
*
First Name
Last Name
Student's Practicum Period (Start and End Dates)
Please rate the student's performance in the following areas:
*
Rows
Professionalism
Communication Skills
Teamwork
Initiative
Technical Skills
Excellent
1
2
3
4
5
Good
6
7
8
9
10
Satisfactory
11
12
13
14
15
Needs Improvement
16
17
18
19
20
Unsatisfactory
21
22
23
24
25
Overall, how satisfied are you with the student's performance?
*
1
2
3
4
5
How satisfied are you with the support provided by the practicum program/university?
*
Not Satisfied
1
2
3
4
Very Satisfied
5
1 is Not Satisfied, 5 is Very Satisfied
What strengths did the student demonstrate during the practicum?
What areas could the student improve upon?
Additional comments or suggestions regarding the practicum experience:
Submit Survey
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