pest wal @ 4 UNIVERSITY OF SOUTH FLORIDA COLLEGE OF NURSING DAILY STUDENT ANECDOTAL NOTE stugentsName Zercce Nets — pete: _2hvalsa. Course ASL semester_ Assigned unit: €12 Number of hours worked on unit: _{(D. 5 erage a NA Mocvat toLeare MUAY Avezage Belew Atpese Paet Assessment a g 5 i Ste g 5 g Sete Docomentton |) 8 5 5 Proteionatmn 8 =| Semmens Kip Hend Leoheite Quanan le des Cogmed G frown. Bf wea a pprebbare wbtlcig cute fax Preceptor Name: Where (Please Print) ig Preceptor Signature: (edi a trree ‘STUDENT EVALUATION OF PRECEPTOR: ‘Check ait hat apply Aboveaverage Average Below Average Knowledgeable oa Encouraged learning Supportive ‘Acts a5 role model Professionalism ooo! ooo000: ‘Comments: Se vin and 1 Way guint Sre fans} Otot Aho hw pahente Cruatp day! LINICAL FACULTY: isagree with evaluations. nts (including prece : (Clinical Faculty Signature ‘Student Signature Revised May 2012