Marywood University ‘Scranton, Pennsylvania’ Depariment of Nuurition & Dieteties Intern Hour Reporting Form ‘Complete this reporting form after each rotation or part of a rotation, Required Hours in: ND 565: Community Nutrition - minimum 160 hours ND 566 : Food Systems Management ~ minimum 224 hours NDS68: MNT ‘o Long Term Care ~ minimum 120 hours (© Acute Care ~ minimum 232 hours Professional Practice following MNT: 96 hours ‘Alternative Practice Experiences: please specify below = 56 hours EHR Go case studies, Coding and Billing Case, Job Description Case Studies If only a fraction of the required hours were completed ata facility ~ please indicate that amount of hours accomplished. Intern: Sauce Hose has completed 56 hours for the rotation MNT (APE) (Mu Proceptor Signature: Intern Signature: