Nurse Extern Peer Reference Form - CHRISTUS Trinity Mother Frances Health System

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Nurse Extern Peer Reference Form

NOTE: Reference must be completed by someone who is not a relative of the applicant.

The applicant is being considered for admission to the Senior Extern Program at Trinity Mother Frances Hospital and Clinics. We are requesting your help to aid the Admissions Committee in assessing the individual's professional and clinical competencies as a student nurse in order to be granted admission. Your cooperation in completing this reference will help the committee gain a better understanding of the applicant.
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Applicant Information

* Do you feel that within the boundaries of a student nurse, this nurse has provided care that is safe and effective?
* Do you feel this applicant has the potential to develop critical decision-making skills?
* Do you feel this applicant has the potential to develop the leadership skills of a professional registered nurse?
* Do you recommend this person for admission?

Your Information