Summer 2024 Level IIA Domestic OOA Consent Form
Fill out this form ONCE. You will be directed to the site specific form after you complete this one.
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Email *
Your name (Last name, First name) *
Group *

“By clicking 'yes' below, I agree to accept the fieldwork placement that the USC OT Fieldwork Team secures for me, a process initiated by this request. 

In the event that I decline the placement that is secured for me, I understand that any new request will be considered only after all students receive an initial placement.”


 *
Required
Communication with fieldwork sites for placement (new or existing) is the responsibility of the Academic Fieldwork Coordinators (AFWCs). Students are encouraged to provide the AFWCs with information about potential sites that are not included in EXXAT, including contact information. By clicking “I agree” below, I am agreeing NOT to contact sites directly. Doing so will put me at risk of losing the opportunity for placement at those sites. *
Required
A copy of your responses will be emailed to the address you provided.
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