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Student Internship Feedback Form
This form is to be filled by internee after completion of internship duration.
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Date
MM
/
DD
/
YYYY
Name of Internee
Your answer
Internship Centre and Rotation Period
Your answer
Name of Supervisor
Your answer
Describe the unit of rotation within the internship setting
Your answer
Describe your role as an intern pharmacist in the internship centre
Your answer
List any activities that you have participated in within the roles stated above
Your answer
Describe any interventions that you have made during the rotation in unit.
Your answer
Describe any challenges that you have faced during rotation and how you overcame them?
Your answer
List the skills you had acquired during the period of rotation?
Your answer
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