Rutgers School of Public Health Department of Health Systems & Policy

Fieldwork Registration Worksheet

DEPARTMENT OF HEALTH SYSTEMS & POLICY (HSAP)

Fieldwork Registration Worksheet

Instructions: Please complete the entire worksheet and obtain a signature on page 3 OR attach an email from your Academic Advisor or Fieldwork Faculty Advisor issuing permission to register. Submit to Fieldwork Coordinator for processing.

Student Name:

Student A #:

Academic Advisor:

Fieldwork Faculty Advisor (If applicable):

Core Courses (15 Credits)

Course Number / Course Name / # of Credits / Semester Completed / Grade
PHCO 0501 / Health Systems & Policy / 3
PHCO 0502 / Principles & Methods of Epidemiology / 3
PHCO 0503 / Introduction to Environmental Health / 3
PHCO 0504 / Introduction to Biostatistics / 3
PHCO 0505 / Health Education & Behavioral Science in Public Health / 3

Required Department Courses (15 Credits) ETHICS

Course Number / Course Name / # of Credits / Semester Completed / Grade
HSAP 0616 / Public Health Ethics and Law / 3

ECONOMICS

Course Number / Course Name / # of Credits / Semester Completed / Grade
HSAP 0615 / Health Care Economics / 3

Choose ONE of the Following Three Courses METHODS

Course Number / Course Name / # of Credits / Semester Completed / Grade
HSAP 0617 / Health Services Research & Evaluation / 3
HSAP 0614 / Health Services and Policy Research Methods / 3
HEBS 0663 / Survey Research Methods / 3

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Rutgers School of Public Health Department of Health Systems & Policy

Fieldwork Registration Worksheet

Student Name:

Student A #:

Academic Advisor:

Fieldwork Faculty Advisor (If applicable):

Choose ONE of the Following Three Courses POLICY

Course Number / Course Name / # of Credits / Semester Completed / Grade
HSAP 0666 / Public Health Policy and Practice / 3
HSAP 0671 / Topics in Health Systems and Health Care Policy / 3
HSAP 9568 / Health Care Policy (Rutgers University) / 3

Choose ONE of the Following Two Courses MANAGEMENT

Course Number / Course Name / # of Credits / Semester Completed / Grade
HSAP 0519 / Managing Health Care Delivery Organizations / 3
HSAP 0665 / Public Health Management and Practice / 3 / .

Electives (9 Credits): Please see HSAP MPH Curriculum for Recommended Electives

http://sph.rutgers.edu/departments/health_systems_policy/index.html

Course Number / Course Name / # of Credits / Semester Completed / Grade

Student Name:

Student A #:

Academic Advisor:

Fieldwork Faculty Advisor (If applicable):

Fieldwork I

Semester eligible to register:

HSAP students must meet the following criteria for Fieldwork I registration eligibility:

Completed all five (5) CORE courses (unless approved by Academic Advisor)

Have an average GPA of 3.0 or higher

Completed at least 4 Departmental Core (unless approved by Academic Advisor)

·  HSAP 0616: Public Health Ethics and Law; and

·  HSAP 0615: Health Care Economics; and

·  Two (2) additional required courses. Please see worksheet.

Complete 27 credits (total)

Approval Department Chair/Associate Dean/Academic Advisor

ADVISOR SIGNATURE:______

Fieldwork II

Semester eligible to register:

HSAP students must meet the following criteria for Fieldwork II registration eligibility:

Completed all Fieldwork I requirements

Have an average GPA of 3.0 or higher

NOTES:

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