Exercise Physiology PEP PlanFor Unit (circle): CXA446 CXA447

Student: __________________________________________________________________________

*Practicum start date: ______________________ Anticipated end date: ________________________

*THESE DATES MUST BE FILLED IN – EVEN IF END DATE IS APPROXIMATE.

Approx. days per week and hours per day (Use following calendar template to plan the detail of practicum blocks)

______________________________________________________________________________________

Site name: _______________________________________________________________________

Supervisor Name: __________________________________________________________________

Site location address and postal address (if different): __________________________________________________________________________________

__________________________________________________________________________________

Supervisor phone number: land____________________ mobile: ___________________________

Supervisor email: ___________________________________________________________________

Any additional information: ______________________________________________________

_______________________________________________________________________________

Signed: Primary site supervisor: ________ ___ Date: ______

Student: _______ ____________ Date: ______

ONCE COMPLETE, THIS DOCUMENT MUST BE UPLOADED INTO INPLACE WITH YOUR SAFETY IN PRACTICE DOCUMENTATION BY DEADLINES SPECIFIED IN UNIT OUTLINE

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Clinical Exercise Practicum

PEP Plan CalendarClinical Exercise Practicum: Summer - Sem 1 - 2018

2016/17 M T W T F S S M T W T F S S M T W T F S S M T W T F S S M T W T F S S

November1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

December1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

January1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

February1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28

March1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

April30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

May1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

June1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Use this calendar to plan your attendance with your Site Supervisor.

When complete, this document must be uploaded into InPlace along with your Safety in Practice documents.

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