| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Hostos Community College - Radiologic Technology Program
Student
Clinical activities
Student
Clinical activities
Student
Clinical activities
Student
Clinical activities
Student
Clinical activities
Student
Clinical activities
Clinical Competency
Clinical Competency Attempted?
Clinical activities
Clinical Competency
Clinical Competency Attempted?
Clinical activities
Clinical Competency
Clinical Competency Attempted?
Clinical activities
Clinical Competency
Clinical Competency Attempted?
Clinical activities
Clinical Competency
Clinical Competency Attempted?
Clinical activities
Were there any disciplinary problems?
Explain
Were there any technical difficulties?
Explain
Were there any patient identification problems?
Explain
Clinical Evaluator's Name
Thank you for your time.

Please click the "Submit" button below to send us your clinical activity report.

Save my progress and resume later | Resume a previously saved form

Contact Information