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    Anesthesia Orientation Checklist

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    The document is a student information sheet and certificate of orientation for a course in Anesthesiology. It collects basic student contact information and has the student confirm that they attended the course orientation. The orientation covered the course policies, schedule of activities, attendance policy, teaching/learning activities, types of exams, and academic integrity policies. The student signs to confirm they understand these policies and expectations for the Anesthesiology course.

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    Anesthesia Orientation Checklist

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    55 views2 pages
    The document is a student information sheet and certificate of orientation for a course in Anesthesiology. It collects basic student contact information and has the student confirm that they attended the course orientation. The orientation covered the course policies, schedule of activities, attendance policy, teaching/learning activities, types of exams, and academic integrity policies. The student signs to confirm they understand these policies and expectations for the Anesthesiology course.

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    The document is a student information sheet and certificate of orientation for a course in Anesthesiology. It collects basic student contact information and has the student confirm that they attended the course orientation. The orientation covered the course policies, schedule of activities, attendance policy, teaching/learning activities, types of exams, and academic integrity policies. The student signs to confirm they understand these policies and expectations for the Anesthesiology course.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    55 views2 pages

    Anesthesia Orientation Checklist

    Uploaded by

    space
    The document is a student information sheet and certificate of orientation for a course in Anesthesiology. It collects basic student contact information and has the student confirm that they attended the course orientation. The orientation covered the course policies, schedule of activities, attendance policy, teaching/learning activities, types of exams, and academic integrity policies. The student signs to confirm they understand these policies and expectations for the Anesthesiology course.

    Copyright:

    © All Rights Reserved
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    of 2

    Anesthesiology AY 2 0 2 3 - 2 4 P a g e |1

    of 2

    STUDENT INFORMATION SHEET

    Name: _____________________________________________________

    Nickname: _____________________________________________________

    Birthday: _____________________________________________________

    Section: _____________________ Class Number: ____________

    Home Address: _____________________________________________________

    Address during school days: ___________________________________________________

    Home Telephone Number: _________________ Cell Phone Number: ___________________

    E Mail Address: _____________________________________________________

    Father’s Name: _____________________________________________________

    Father’s Occupation _____________________________________________________

    Mother’s Maiden Name: _____________________________________________________

    Mother’s Occupation _____________________________________________________

    Medical Illness: _____________________________________________________

    Person to contact in case of emergency __________________________________________

    Contact no. _____________________________________________________

    Signature: _____________________________________________________

    UST: A002-46-FO02

    Anesthesiology AY 2 0 2 3 - 2 4 P a g e |2
    of 2

    CERTIFICATE OF ORIENTATION in Anesthesiology and Perioperative Medicine

    This is to certify that

    Yes No 1. I attended the orientation on the course policies of the Department of


    Anesthesiology and Perioperative Medicine for AY 2023-2024.
    Yes No 2. I was welcomed to the course of Anesthesiology.
    Yes No 3. I was oriented to the schedule of activities.
    Yes No 4. I am aware that my attendance will be checked and it will have a bearing on
    my final grade.
    Yes No 5. I am aware that excused absences include only the following:
    • Death in the immediate family to include grandparent
    • Medical illness of the student (with proof)
    Yes No 6. I was oriented to the different teaching learning activities.
    Yes No 7. I am aware that I will be held responsible for learning activities missed due to
    unforeseen cancellation or suspension of classes.
    Yes No 8. I am aware that during class hours, electronic gadgets are to be used for
    educational purposes only.
    Yes No 9. I was oriented to the types of examinations both formative and summative
    and on how to seek clarification for posted answers as well as how results
    will be made known to students.
    Yes No 10. I am aware that the final arbiter of questions and answers for quizzes and
    examinations is the official textbook entitled, Clinical Anesthesiology by
    Morgan 14th ed.
    Yes No 11. I am aware that cheating is NOT allowed and will be dealt seriously based on
    the policies stipulated in the rules and regulations of the student handbook of
    UST Faculty of Medicine & Surgery.
    Yes No 12. I am aware that as a Thomasian student and a future Thomasian doctor, I
    must exhibit proper decorum as stipulated in the rules and regulations of the
    student handbook of UST Faculty of Medicine & Surgery.
    Yes No. 13. I was oriented to the grading system of the department.
    Yes No 14. I am aware that I must abide by the DATA PRIVACY ACT OF 2012.
    Yes No 15. I am aware that a group chat shall be created per subsection and it will serve
    as our source of communication with our facilitators.
    Yes No. 16. I was introduced to the academic staff of the department.

    I hereby attest that I have read and understood the Department of Anesthesiology and
    Perioperative Medicine Rules & Regulations for AY 2023-2024.

    Signature _________________________
    Name _________________________
    Date _________________________

    UST: A002-46-FO03

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