Dental Assisting Practicum Evaluation Form

COMMUNITY COLLEGE DENTAL ASSISTING PROGRAM PRACTICUM EVALUATION FORM Student Name Externship Office Your evaluation of this student’s practicum experience helps identify areas in which the student is strong as well as those where improvement is needed.. 4 EXCELLENT Performs at an exceptionally high level 3 GOOD Performs somewhat above an average or satisfactory level 2 FAIR Performs mostly at an average or satisfactory level 1 POOR Performs below average work not satisfactory NA Student had no opportunity to perform this task 4 Excellent 3 Good 2 Fair 1 Poor