GORDON COLLEGE

College of Allied Health Studies

Tapinac Oval Sports Complex, Donor St., East Tapinac, Olongapo City

15 June, 2022

Dear Parents/Guardians:

This is to inform you that the BSN level IV students will be having their Related Learning
Experience as part of the requirements in the subject, NCM 116a ( Care of client with problems in
Nutrition, Gastro-intestinal metabolisn and endocrine perception and coordination, acute and
chronic).

The students will be performing their duties at ____________________ every Tuesday and
Wednesday starting _______________ until ______________ from 8:00 am to 5:00pm for
conducting Health Center Activities ( Prenatal Care, Immunization, Consultations and Home visits).

Please affix your signature on the space provided below and have your son/daughter/ward submit it
to their Clinical instructor in charge.

Rest assured that we are one with you in assisting your child/ward in his/her total holistic
development in the Nursing Profession.
Thank you very much.

Very truly yours,

Thea Camille T. Samonte, RN MAN

Dean, College of Allied Health Studies

_____________________________________________________________________________________

Acknowledgement Form

I have read the objectives and guidelines of the practicum of my

son/daughter/ward_____________________________ and I am fully aware that he/she should strictly
follow the said guidelines. I understand that the activities under this subject is a part of their BSN
curriculum.

I am also waiving the school’s responsibility to any untoward incident that may happen beyond human
control during performance of their activities.

___________________________ ___________________
Parent/ Guardian Date
Signature over printed name