Appendix A: Health Forms

• Year 1 Health Forms with GuideLines (PDF)
• Year 2 Health Forms (PDF)

Appendix B: WSIB Student Declaration of Understanding

• Declaration of Understanding

Appendix C: Students on Unpaid Work Placements Accident Report

• Students on Unpaid Work Placements Accident Report Form (PDF)

Appendix D: ACE INA Claims Form

• Accident Report (PDF)

Appendix E: Interprofessional Education

• IPE Requirements – Fieldwork (PDF)

Appendix F: Fieldwork Record

• Fieldwork Record

Appendix G: Request for Special Consideration Form

• Request for Special Consideration Form (PDF)

Appendix H: Fieldwork Placement Change Request Form

• Fieldwork Placement Change Request Form (PDF)

Appendix I: Travel Allowance Request Form

• Travel Allowance 2019-2020

Appendix J: International Placement Forms

• International Fieldwork Placements Documentation Checklist and Reference Form (Fillable PDF)
• Consent Form and Release from Liability
• International Travel Allowance – Policy and Form

Appendix K: Confirmation of Understanding of Student Responsibilities Form

• Student Responsibilities Form (PDF)

Appendix L: Fieldwork Issues Flow Charts

• Fieldwork Issues Flow Charts (PDF)

Appendix M: Learning Objectives

• Learning Objective Chart, Evaluation Guide, and Useful Verb Chart (PDF)

Appendix N: Fieldwork Placement Coding Sheet

• Placement Offers Coding Sheet