Please attach in an email to badgett@uthscsa.edu or fax back to 567-4423 by or on the first day of the rotation.
Your name: ______________________________________
Month/year: ______________________________________
| Monday | Tuesday | Wednesday | Thursday | Friday |
| Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
| Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
| Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
| Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Date:
AM PM
|
Attending signatures:
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________