Sanford School of Medicine Center for Disabilities

Dietetic Internship - Intern Forms

The following forms are for Dietetic Interns at the Center for Disabilities. Current Dietetic Interns with questions regarding the use of the forms, contact the Dietetic Internship Director.

Dietetic Internship Forms

Confidentiality Policy
Academy of Nutrition and Dietetics (AND) Code of Ethics
Reflective Journaling Guidelines
Dietetic Internship Expectations
Dietetic Internship Portfolio Requirements
Peer Reviewed Journal Article Reviews
Documentation of Dietetics Education Form
Non-Rotation Specific Competency Assignments 

Clinical Rotation Forms

End of Clinical Rotation Evaluation Form 
Evaluation of Oral Presentation Form 
Nutrition Case Study Format
Clinical Competency Assignments 
Case Study Grading Rubric

Community Rotation Forms

Documentation of Hours Form
Community Faculty Observation of Student Form
Evaluation of Oral Presentation Form
Community and Concentration Competency Assignments
Case Study Grading Rubric

Management Rotation Forms

End of Management Rotation Form
Evaluation of Oral Presentation Form
Special Event Evaluation Form
Management Competency Assignments
Patient Tray Audit
Plate Waste Form
Plate Waste Report Grading Rubric
Portion Size Grading Rubric
Business Plan Grading Rubric
Make or Buy Study Grading Rubric
Motion Study Grading Rubric

Site Visit Forms

Clinic Site Visit Form - Preceptor
Clinic Site Visit Form - Intern
Management Site Visit Form - Preceptor
Management Site Visit Form - Intern

Evaluation Forms

Evaluation of Rotation Experience 
Preceptor Rotation Evaluation Form
Guidelines for Completion of Professional Development Forms 
Professional Development Form
Self-Assessment Form 

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