EM Clerkship - End of Shift evaluation

Student Information

Students: Please complete this page and select your evaluator on the next page. Following this please have the faculty member complete the remainder of the evaluation.

Question Title

* Last name

Question Title

* First Name

Question Title

* Shift Date

Please enter the shift start time and the date (on which the shift started for overnight shifts)

Date

Time

AM/PM

Question Title

* Clerkship Site

Rush

Stroger

11% of survey complete.