MPH Student Pre-Site Visit Form

Office of Field Education
MPH Pre-Site Visit Survey

This survey is to be completed by you, the student, and when finished, will trigger a survey that goes to your field instructor for their input. You will have the opportunity to select the concentration that applies to your specific field of study. It will be helpful for you to have your ELA available as you complete this pre-site visit form.

Student Information:

First name

Last Name

Email Address

Practicum Organization

Practicum Information:

Field Instructor First Name

Field Instructor Last Name

Email Address

Field Faculty Liaison

Kate Barbier (MPH)

Sunghei Han

Tammy Orahood (international practicum)

Jewel Stafford