Thank you for your support in providing fieldwork experiences to our OTA students! On this page you will find resources and information about the Fieldwork Education Experience required by Polk State College. Pertinent forms and documents have been posted for easy access.

You will need to click on the form, then SAVE AS, complete the form, SAVE again, then submit the form via email to the Academic Fieldwork Coordinator.

General Information

  • FLOTEC FW Data Form
  • Students With Disabilities – AOTA Advisory Opinion
  • HIPPA Guidelines for FW
  • Medicare Guidelines for Supervision of Students

FW Course Information

The syllabus for each fieldwork rotation and the associated objectives are accessed through the links posted below. Please keep in mind that these objectives are to serve as guidelines. They allow for flexibility dependent upon your facility and the learning experiences available.

  • OTH 1800 – Fieldwork Level I, Psychosocial
  • OTH 2841 – Fieldwork Level II, Psychosocial
  • OTH 2840 – Fieldwork Level II, Physical Dysfunction

Forms and Official Documents

  1. FW Level I
    • Blank Project Rubric
    • Fieldwork Educator Effectiveness
    • Jr. Student Data Form
    • Level I Student Performance Evaluation
    • Suggested Learning Experiences
    • Student Evaluation of Fieldwork Facility
    • Weekly Journal
    • Weekly Learning Plan
  2. FW Level II
    • Blank Project Rubric
    • Blank Senior Student Data Form
    • Fieldwork Educator Effectiveness
    • FLOTEC OTA Site-Specific Objectives Form
    • Student Evaluation of Fieldwork Facility
    • Suggested Learning Experiences
    • Weekly Journal
    • Weekly Learning Plan
  3. Fieldwork Educators Forms
    • Self Assessment Tool for FW Educator Competency
  4. AOTA Official Documents
    • Code of Ethics
    • OT Practice Framework
    • Standards of Practice
    • Supervision, Roles and Responsibilities
    • ACOTE Academic Standards