Confirmation of Fieldwork Educator’s Professional Qualifications
In order to comply with accreditation standards of the Accreditation Council for Occupational Therapy Education (ACOTE), the department must verify that each fieldwork educator is qualified to supervise Level II students. Please assist us by completing the form and returning it prior to the start of the student’s fieldwork experience.
I, ______________________________ confirm that __________________________________________
Fieldwork Coordinator Fieldwork Educator Name and Credentials
has a minimum of one year of practice experience subsequent to initial certification and is adequately prepared to serve as a fieldwork educator.
Fieldwork Coordinator Signature Date