Template Downloads

Most students or their education provider will provide you with the necessary paperwork. However here are some templates that you might find useful[1].

Template
Description
Download
Health service student agreementThis provides the template to form an agreement with individual students for their placement.
Patient Consent TemplateProvides a template for patient consent for participation in care by students.
Patient Information Flyer TemplateProvides the basis for a flyer to inform patients regarding student placements in your facility.
Patient satisfaction questionsProvides some sample questions you may wish to include in your patient satisfaction survey regarding student placements.
Placement Confirmation Letter TemplateThis is a standard letter confirming to the student that you will be taking them. It outlines when and where for the students to meet and what to bring.
Insert specific details and amend as required.
Placement Learning Contract TemplateThis provides for the student to detail their learning goals and objectives for the placement
Orientation ChecklistThis provides a template to develop a comprehensive student orientation checklist.
Orientation Handbook Contents TemplateThis provides a comprehensive list of potential contents to be included in Student Orientation Handbook.
Student Confidentiality Agreement TemplateProvides a template for an agreement by the student to adhere to relevant policies. It also provides a useful list of examples of breaches in relation to privacy, confidentiality and security of information.
Placement Planner TemplateA template for creating a weekly planner to allocate student to activities.
Survey Evaluation TemplateA survey to assess the quality of the placement from the students’ perspective.
Pre-placement SurveyA survey tool to send to students prior to their commencement to ensure they have given appropriate consideration to their placement.

[1] Many of these templates have been taken or adapted from the Victorian he Best Practice Clinical Learning Environment (BPCLE) Framework