2024-2025 Level IIB + Capstone International OOA Consent Form
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Your name (Last name, First name) *
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“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.

If I am assigned a placement that is secured for me between March 6th and October 1st, I have 60 days to decline this placement. 

In the event I need to make any changes to this request, I will communicate these changes immediately to the Fieldwork Team.

In the event that I decline the placement that is secured for me AFTER October 1st, I understand that this will affect my eligibility to participate in other placement processes.” *
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. *
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A copy of your responses will be emailed to the address you provided.
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