Wellness - Expectation Statement Worksheet B
This form is used in conjunction with Workhseet A to indicate how each expectation and objective of the internship was achieved, providing an explanation for each.

From Workhseet A (completed at the beginning of the internship) indicate how each expectation and objective was achieved, providing an explanation for each. The Intern and Internship Supervisor should work together to review the progress toward meeting the original expectations and objectives and report how future planning may be improved or enhanced to help meet those expectations and objectives not met, and possibly exceed those which were met. Differing views may occur and are expected, and should be reported accordingly.

This assignment should be submitted through this site. If you prefer to mail or fax the form please send it to the Program Director of Wellness Management at the Fisher Institute for Wellness and Gerontology prior to the end of week # 15 (week #10 during summer semester).

Items with an * indicate a required field.
Intern Information
Today's Date *    
Due Date *    
Intern's Name *
Address *
City *
State *
Zip *
Country
Phone *
Fax *
Email *
 
Internship Supervisor Information
Internship Supervisor's Name *
Title *
Internship Site *
Address *
City *
State *
Zip *
Country
Phone *
Fax *
E-mail address *
 
Expectations & Objectives
Expectation/Objective #1 *
How was it achieved?
Include explanation *
Expectation/Objective #2
How was it achieved?
Include explanation
Expectation/Objective #3
How was it achieved?
Include explanation
Expectation/Objective #4
How was it achieved?
Include explanation
Expectation/Objective #5
How was it achieved?
Include explanation
Expectation/Objective #6
How was it achieved?
Include explanation
Expectation/Objective #7
How was it achieved?
Include explanation
Additional Expectations/Objectives
How were they achieved?
Include explanations
 
Recommendations and Comments Regarding the Expectations
From the Intern
From the Internship Supervisor
Intern has approved worksheet *  Yes
  No
Internship Supervisor has approved worksheet *  Yes
  No
Date *