<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" bgproperties="fixed" background="02c285a1erlcgo.png"> <div> <FONT SIZE="5" COLOR="#FFCC66" FACE="Arial" ><B>Durant Family Medicine Clinic</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="Durant Family Medicine Clinic"><B>home</B></A></div> <div> <A HREF="id33.htm" TARGET="_top" TITLE="Call">Call</A>   |   <A HREF="id42.htm" TARGET="_top" TITLE="EVENTS">EVENTS</A>   |   <A HREF="id34.htm" TARGET="_top" TITLE="Rotation Schedule">Rotation Schedule</A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="Resident Contact Information">Resident Contact Information</A>   |   <B> </B></div> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="02ad2c00dkelyh.png"> <div> Links to pages for evaluation of Intern, Residents, and Rotations.</div> <bR> <div> <IMG SRC="2b8c6790.png" border=0 width="198" height="121" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> </td> <td valign="top" height=390 width="100%" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I> </I></div> <bR> <bR> <div> Intern / Residents Evaluations and Reports </div> <bR> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form464083608/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form464083"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Attestations statement of 80 hour work. (to be completed monthly)</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form992866600/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form992866"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Intern / Resident Evaluation of Rotation</div> <div>   </div> <bR> <div>                         </div> <div> <A HREF="http://fs19.formsite.com/DFMC/form995848377/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form995848"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Request for Vacation, Moonlighting, and Leave of Absence</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form090792707/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form090792"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Med 360</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form485330352/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form485330"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Resident Professionalism Evaluation</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form466210355/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form466210"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Resident Evaluation of Clinical Faculty</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form944244951/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form944244"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Request to Change Rotations</div> <div>            </div> <bR> <div> <I>Faculty Evaluations of Intern / Resident</I></div> <bR> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form675531092/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form675531"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern / Resident - Family Medicine</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form005803174/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form005803"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern/Resident - Otorhinolaryngology</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form001309236/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form001309"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern  - Hospital Based Obstetrics and Gynecology</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form673992004/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form673992"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern / Resident - Emergency Medicine</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form605024913/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form605024"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern / Resident - Critical Care</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form502007978/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form502007"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern/Resident-Internal Medicine   </div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form680081713/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form680081"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern/Resident--GYN</div> <div>  </div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form002453877/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form002453"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern/Resident--Ophthalmology </div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form004248337/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form004248"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern/Resident--Orthopedics</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form006625543/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form006625"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Intern/Resident--Pediatrics</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form009569509/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form009569"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>            Faculty Evaluation of Resident---Radiology         </div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form010987223/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form010987"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Resident--Sports Medicine</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form011700242/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form011700"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Resident--General Surgery</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form100405210/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form100405"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Wound Care</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form112321071/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form112321"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Newborn Nursery</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form400738264/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form400738"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Dermatology</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form103663804/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form103663"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Anesthesia</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form894988274/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form894988"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>           Faculty Evaluation of Night Intern</div> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form312377831/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form312377"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>            Faculty Evaluation of Urology</div> <bR> <div> <I><B>Quarterly Evaluation of Intern / Residents</B></I></div> <bR> <bR> <bR> <div> <A HREF="http://fs19.formsite.com/DFMC/form263763165/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form263763"><IMG SRC="2ba0f0f0.gif" border=0 width="15" height="15" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></A>      <FONT SIZE="4" COLOR="#330033" FACE="Arial" ><B>Quarterly Evaluation</B></FONT></div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> </td> </tr></table></body>