EmailMeForm
Remedial Application Request in Meditrek
Please use this form to request a remedial application in Meditrek if you have an Incomplete Grade from a practicum course and need to log practicum hours after the term.
Student Name
*
First
Last
Student ID
*
Walden University Student E-mail Address
*
Confirm E-mail
Current Program:
*
Please select
RN-BSN
RN-MSN
MSN
DNP
PMC - Post Master's Certificate
Current Specialization:
*
Please select
Adult Gerontology Primary Care Nurse Practitioner
Adult Acute Care Nurse Practitioner
DNP
Education
Family Nurse Practitioner
Informatics
Nurse Executive
Pediatric Nurse Practitioner
Psychiatric Health Nurse Practitioner
Public Health
Academic term for which you will be logging practicum hours for the Incomplete Grade (current term you need to log hours not the term you received the incomplete grade):
*
Please select
Fall
Winter
Spring
Summer
Academic Year for which you will be logging practicum hours for the Incomplete Grade (e.g. 2020, 2021):
*
Practicum Course Number for which you will be logging practicum hours for the Incomplete Grade:
State/Country Where Practicum Will Occur:
*
Please select
Outside of United States
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
I verify that I have an Incomplete Grade and I am eligible for a remedial application. I understand that remedial applications are only for students that need to complete practicum hours from the last term with an Incomplete Grade.
*
Yes
I understand that I must receive practicum approval for this remedial application in Meditrek prior to logging practicum hours:
*
Yes
No
I understand that I must have all my onboarding requirements updated in CastleBranch in order to be approved for this term, including Professional Liabilty Insurance:
*
Yes - All my onboarding requirements are updated in CastleBranch.
Yes - I am working on updating my onboarding requirements in CastleBranch.
No
Additional Comments (Optional):
Please use this section to provide additional details about the change needed or any comments.