VM 22300 Clinical Mentorship DocuSign Links

Beginning for the spring 2020 semester, all clinical mentorship documents will be completed using DocuSign.  Below are links and directions for completing all four mentorship documents.  

Clinical Mentorship and Facility Requirement Agreement – When you click on this link, a page will open that will require you (the student) to enter your name and Purdue email address.  You will then need to enter the name of the practice owner or designee and their email address.  DocuSign will guide you through the document until you have completed the student portion of the document.  Once completed, it will be sent automatically to the email address you provide for the practice owner or designee so they can complete their part of the form.

Student Acknowledgment Form – When you click on this link, a page will open that will require you (the student) to enter your name and Purdue email address.  This form has several links to information that you will need to read, then check the appropriate checkboxes and sign/date at the bottom.

Professional Liability Insurance Coverage – When you click on this link, a page will open that will require you (the student) to enter your name and Purdue email address.  Professional liability coverage for clinical mentorships lasts for up to a year and runs from Aug. 1 through July 31stYou only need to complete this form once a year.  This $13 fee is billed through the Bursar’s Office allowing it to be paid in the same manner that tuition is paid.

Clinical Mentorship Supervisor Agreement – When you click on this link, a page will open that will require you (the student) to enter your name and Purdue email address.  You will also need to enter the name of the credentialed veterinary technician or licensed DVM who will be your clinical mentorship supervisor along with their email address.  DocuSign will guide you through the document until you have completed the student portion of the document.  Once completed, it will be sent automatically to the email address you provide for your clinical mentorship supervisor so they can complete their part of the form.  If you have multiple supervisors, a separate agreement must be completed for each supervisor that will sign your Task Verification forms.

VM 22300 Clinical Mentorship logbook

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