* 1. Please enter the following information:

* 2. Branch of Armed Services:

* 3. Are you a:

* 4. Date of Arizona Burn Center Clinical:

Please Specify:

* 5. Which of the following were you able to observe during your AZBC clinical rotation?

* 6. Did you have the opportunity to perform procedures within your scope of practice?

  Yes No
Burn wound dressings
Debridement of acute burns in the burn emergency department
Versa jet
Tangential excision debridement
Harvest skin
Placement of skin graft
Application of Negative Pressure Dressing

* 7. Did the AZBC clinical rotation better prepare and/or enhance your ability to care for a burn patient?

* 8. What was the most valuable or beneficial aspect about your rotation?

* 9. What was the least valuable or beneficial aspect of your rotation?

* 10. Have you been deployed since your AZBC clinical rotation?

* 11. If deployed, did you care for burn patients while deployed?

* 12. Is there any Arizona Burn Center Staff member you would like recognize?

Please know that your time, effort and comments are greatly appreciated. This information will be shared and used to improve future Arizona Burn Center clinical rotations.

Thank you for your service,

Suzanne Buchanan RN, BSN, CCRN
Arizona Burn Center Outreach Educator