Questions will adjust based on responses.
EmailMeForm
Request for Standardized Patient (SP)
Standardized Patient Program, McMaster University
1
Student Initiated Sessions
2
SP Safety
3
Requester Details
4
Learner/Program Information
5
Multiple Booking Request
6
Session Information
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1
Student Initiated Sessions
2
SP Safety
3
Requester Details
4
Learner/Program Information
5
Multiple Booking Request
6
Session Information
7
Session Format
8
Virtual Session Information
9
In-Person Location
10
Facilitator Details
11
Case/Scenario Information
12
Physical Examinations
13
Is this a student initiated session?
*
No
Yes
All student initiated/led sessions must have a supervisor who will be present AT ALL TIMES during an SP session. This individual must be someone who is approved to instruct by the program of the requesting learners (i.e. tutor, preceptor). Information about this person will be collected later in the form.
Do you agree that there will be a supervisor present AT ALL TIMES during the SP session?
*
Yes
No
All student initiated/led sessions will need to provide billing information from their program in order to request an SP. The SP Program will invoice the university program directly, and the student group is to reimburse their program.
University chartfield information is to be provided to spadmin@mcmaster.ca before an SP booking will be confirmed.
*
I have approval from my program, and will send chartfield information to spadmin@mcmaster.ca
I do not have approval from my program for billing
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