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March 28, 2025
Who is completing this evaluation (what is your role)?
Student (Self Assessment)
Attending (Preceptor)
Resident/Fellow (Preceptor)
Student Information
(A copy of the completed form will be sent to the SUNY COM Clerkship Director and to the student at the email entered here).
Student First Name
Student Last Name
Student ID (SID)
Student Email
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