Surgical Technology Student Conference Acknowledgement
Once the student conference meeting is completed, this form will be submitted by the student.
Student Name
*
First Name
Last Name
Student Email
*
example@example.com
I acknowledge receiving and/or reviewing the following information with my instructor(s). I also understand these forms will be placed in my student file.
*
SoMoTech Surgical Technology Scrub Evaluations
SoMoTech Clinical Hours & Experience Verification
Case Procedure Summary
Case Procedure Report (SoMoTech validates cases)
Clinical Conference Form
Employability Rubric
Conference Date
*
-
Month
-
Day
Year
Date
Student Signature
Submit
Should be Empty: