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Pre-Clinical Exam Form 

Prior to beginning a student teaching practicum as part of the Early Childhood Education Program, a student must have a health examination and meet current vaccination requirements (this includes a 2-step TB test).

Completed health forms are due prior to starting any practicum. If you do not return the completed per-clinical exam form to the Health Services office by the deadline you will NOT be permitted to continue enrollment in the class and will be withdrawn.

Please click on the Pre-Clinical Exam Form to access the document that you need to take to your health care provider and turn documentation into:

Ellen Montour
Health Services office A164 (Appleton Campus)

or mail to:

FVTC Health Services
1825 N. Bluemound Drive
Appleton, WI 54912
Early Childhood Education photo

   Maintained by:

   Kayla Krepline

   Last Modified:
   12/4/2013 12:01:07 PM