NLU PA Program — Didactic Year Handbook
Forms
The forms referenced throughout this handbook are reproduced below in template form. Program- managed electronic versions (e.g., in the learning management or clinical tracking system) govern where a discrepancy exists.
Didactic Remediation Form (Quick-Reference Summary)
The abbreviated fields below may be used for a quick, in-course remediation note. The Program’s official, ARC-PA A3.16-aligned remediation record is the Student Remediation Documentation, Tracking, and Annual Audit Form, reproduced in full later in this Forms section; that form governs whenever documentation is placed in a student’s permanent educational record.
Student Name: _______________________________________________________
Course: _______________________________________________________
Assessment / Topic Area(s): _______________________________________________________
Date of Original Assessment: _______________________________________________________
Score: _______________________________________________________
Remediation Plan (attach if lengthy): _______________________________________________________
Reassessment Date: _______________________________________________________
Reassessment Score: _______________________________________________________
Course Director Signature / Date: _______________________________________________________
Student Signature / Date: _______________________________________________________
Performance Improvement Plan
Student Name: _______________________________________________________
Area(s) of Concern: _______________________________________________________
Improvement Plan / Action Steps: _______________________________________________________
Timeline: _______________________________________________________
Follow-Up Date: _______________________________________________________
Faculty Signature / Date: _______________________________________________________
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