St. Bonaventure University

St. Bonaventure University MSOT Program
Level II Fieldwork Educator Attestation Form


ACOTE Standard C.1.11:
This accreditation standard requires that the SBU-OT program shall:
    “Document and verify that the student is supervised by a currently licensed or otherwise regulated occupational therapist who has a minimum of 1 year full-time (or its equivalent) of practice experience as a licensed or otherwise regulated occupational therapist prior to the onset of the Level II fieldwork. Ensure that the student supervisor is adequately prepared to serve as a fieldwork educator prior to the Level II fieldwork. The supervising therapist may be engaged by the fieldwork site or by the educational program.” [August 2022 Interpretive Guide Version of the 2018 ACOTE Standards and Interpretive Guide (effective July 31, 2020)]
ACOTE Standard C.1.12:
This accreditation standard requires that the SBU-OT program shall:
    “Document a mechanism for evaluating the effectiveness of supervision (e.g., student evaluation of fieldwork) and for providing resources for enhancing supervision (e.g., materials on supervisory skills, continuing education opportunities, articles on theory and practice).” [August 2022 Interpretive Guide Version of the 2018 ACOTE Standards and Interpretive Guide (effective July 31, 2020)]

 

Fields with an asterisk are required.

Name & credentials of supervising OT





Fieldwork site information





Attestation:

By submitting this form, I verify that I have received access to and have reviewed fieldwork educator resources provided by St. Bonaventure University’s Occupational Therapy Department for enhancing supervision of the MSOT student.




Upon successful submission of this form you will be taken to an acknowledgment page confirming that the form has been dispatched. If you do not go to the acknowledgment page, please check to see that all required questions have been answered and submit again. If you have questions or issues, contact Amy Hayden, OT administrative assistant, at (716) 375-2576 or by email.