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Request for Absence from Clinical Experience Mobile App

This mobile application allows a student to ask for time off from clinical experience. The application asks for the applicant's name and student number. Then is asks for the time they want off, why, and their replacement. Then it has a signature place.

  • Lendlease
  • The Cooperative
  • PG&E
  • oxy
  • Red Bull
  • Mirvac

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Take a peek inside the Request for Absence from Clinical Experience Mobile App

Included Features

Our App Builder gives you the power to easily add and remove the ones you want. {{controller.show_all ? 'See included features.' : 'See more features.'}}

  • {{data.title}}

Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox

    Name of Student

  • Ico textbox

    Student #

  • Ico statictext

    I am requesting advance approval for absence from assigned clinical experience(s) on the dates an...

  • Ico textbox

    Assigned Clinical Experience

  • Ico statictext

    Time

  • Ico time

    From

  • Ico time

    To

  • Ico statictext

    Date

  • Ico date

    From

  • Ico date

    To

  • Ico multiline

    Possible Replacements

  • Ico multiline

    Further details of Clinical Experience on dates requested to be excused:

  • Ico multiline

    Reason for Absence:

  • Ico date

    Date Submitted:

  • Ico date

    Date Received

  • Ico multiline

    Replacement coverage (if applicable):

  • Ico multiline

    Alternative Schedule (if applicable):

  • Ico date

    Date

  • Ico signature

    Signature

  • Ico date

    Date

  • Ico signature

    ATS Signature

  • Ico date

    Date

  • Ico signature

    Approved By

  • ...and More!

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