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Elective Evaluation Form

This form is for regular Satisfactory/Unsatisfactory electives. (There is a different form for Individualized CAE rotations found here.)

Clinical Supervisors are requested to submit an evaluation of student performance within 2 weeks after the student has completed an off-site experience.

Please contact CVMPPS@osu.edu if you have any questions.


Please provide the name of the student who completed the elective experience.
Please provide the name of the location/practice where the student completed the elective experience.
Please provide the name of the advisor who supervised the student during their elective experience.
Please provide the date the student began their elective experience.
Please provide the date the student ended their elective experience.
Please provide a grade you believe the student achieved during their elective experience.
Students will receive a copy of their evaluation.
(xxx) xxx-xxxx
Please provide a telephone number where you may be reached regarding these evaluation comments, if necessary.
Please provide an email address where you may be contacted regarding these evaluation comments, if necessary.