Intern Initial Interview with Clinical Educator

Please complete this form as you take notes during the initial conversation with your placement's clinical educator. A copy of this initial interview form will be submitted to the clinical educator and the Office of Field Experiences.

This initial interview should be done within three weeks from the time you were informed of your placement or as soon as possible.

All interns will complete this initial interview for each placement.

For your convenience, here is a blank form you can print out to write on: Intern Initial Interview with Clinical Educator

<February 2026>
SuMoTuWeThFrSa
25262728293031
1234567
891011121314
15161718192021
22232425262728
1234567
mm/dd/yyyy
<February 2026>
SuMoTuWeThFrSa
25262728293031
1234567
891011121314
15161718192021
22232425262728
1234567
mm/dd/yyyy
<February 2026>
SuMoTuWeThFrSa
25262728293031
1234567
891011121314
15161718192021
22232425262728
1234567
mm/dd/yyyy
Interview Questions
2/4/2026 11:24:43 AM
Anti-Spam Verification
Important: Click the 'Submit' button ONCE in a session. If you are unsure your form was submitted OR you got a 'critical error' notice in a pink box after form submission, please contact Kellie Hatch to verify if the form was submitted successfully.