Master of Occupational Therapy Program - Governors State University

Policy: Level I Experience Number: OT 604 Page 2 of 2
8.0 Site supervisors are sent the following information prior to the assignment:
8.1 a letter introducing the student, confirming the dates of the assignment and
instructor and AFC contact information.
8.2 signed release of all student information held in the AFC's locked file (see
attached sample)
8.3 objectives of the Level I experience
8.4 co-requisite course information as determined by course instructors.
8.5 the student evaluation form to be completed by the site supervisor
8.6 HIPPA information
9.0 The quality and congruence with the curriculum design is monitored on a regular basis by
a variety of means which may include: on-site visit, phone calls, written survey, student
and/or site feedback.
10.0 Level I supervisors are qualified personnel. Examples include:
10.1 occupational therapist
10.2 occupational therapy assistant
10.3 psychologist
10.4 physician assistant
10.5 teacher
10.6 social worker
10.7 nurse
10.8 physical therapist
10.9 recreation therapist
10.10mental health worker
11.0 All students must successfully pass the Level I courses to progress in the program.
Individual evaluation of each Level I student is documented by the site supervisor and
becomes part of the student course work records.