Student Name:
Course:

Check one: Midpoint Review Final Review

Using the Midpoint or Final Review checklist of questions as a guide, answer the following:

1. Does the student’s progress demonstrate the ability to practice at the expected level for completion of this course?

2. What are the student’s greatest strengths?

3. Are there any areas or skills that need improvement?

4. What is your overall evaluation of this student?

5. The student’s abilities:

Meet the course evaluation criteria

Fail to meet the course evaluation criteria

Preceptor Signature:
Date Signed:

Preceptor Name:

Address:

If needed, please use the other side for additional comments.