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    Student Evaluation of Site Preceptor and Field Placement Experience

    Please complete this evaluation of your Field Placement experience, and submit it within one week of the conclusion of your Field Placement.

       *Required Field
       
    Name*
       
    Email Address*
       
    Phone Number*
       
    Field Placement Location*
       
    Site Preceptor*
       
    Faculty Advisor*
       
       
    Part I. Assessment of Site Preceptor
       
    1. Please evaluate your Site Preceptor on the following.
        My Site Preceptor . . .
          a. Provided sufficient orientation regarding the site's policies and procedures.*
          b. Facilitated opportunities to apply knowledge and skills acquired in MPH courses.*
          c. Assisted me in achieving my learning objectives and competencies.*
          d. Communicated with me and provided feedback throughout the experience.*
          e. Provided insight into potential career opportunities.*
       
    2. Would you recommend your Preceptor to other students?*
        Why or why not?
          
       
       
    Part II. Assessment of Field Placement Experience
       
    3. Please evaluate your Field Placement experience on the following.
        My Field Placement experience . . . 
          a. Provided the opportunity to gain new knowledge and skills.*
          b. Provided an environment conducive to applying new knowledge and skills.*
          c. Assisted me in achieving my learning objectives and competencies.*
          d. Was a beneficial component of the MPH curriculum.*
          e. Contributed to my career development in public health.*
       
    4. Would you recommend the Placement Site to other students?*
        Why or why not?
          
       
       
    Part III.  Please share your thoughts and feedback, including suggestions for improvement, related to:
       
      a. Faculty Advisor  
          
       
      b. Site Preceptor  
          
       
      c. Site Placement  
          
       
      d. Program Coordinator  
          
       
       
    By typing my name below, I certify that the information provided in this form is complete and accurate, and I submit this evaluation of my Site Preceptor and Field Placement experience.
      Signature*
      Date*