Student Mid-term Evaluation
Facility
Intern
Date
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Month
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Day
Year
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Hour
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10
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50
Minutes
AM
PM
AM/PM Option
Are you meeting with your supervisor on a weekly basis?
Yes
No
Is this experience what you expected?
Yes
No
Is this experience what you expected? Explain:
Is the supervision you are getting adequate?
Yes
No
Is the supervision you are getting adequate? Explain:
How can the internship be more meaningful?
What can you do to make it so?
What can the facility do to make it so?
What experience would you like to see given more emphasis during the remainder of your time with this facility?
Have you been able to complete assigned PGA/PGM work activities?
Yes
No
If so, which modules have you completed thus far?
Regarding the PGA/PGM work activities, are you receiving adaquate support from the professional staff?
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