Review the instructions and complete the Annual Report (AR) as described to ensure a thorough, accurate and timely submission. The Annual Report, required documentation and any applicable fees must be received by your program’s assigned date. Submission of hard copies will not be accepted. Send the documentation via e-mail to . Fees should be sent via a traceable method (i.e., UPS, FedEx). Failure to return your completed AR will result in Administrative Probation.

Completing the Annual Report

  1. Fill in the cells of all three tabs/worksheets. Click on a cell to view its entire contents. Highlight changes you make.
  2. Information Tab: Ensure names, dates, phone and fax numbers, website and e-mail addresses are correct and up-to-date.
  3. As a reminder administrative changes must be provided in writing to the JRC-DMS.
  4. Enter the “Person Preparing,” “Date submitted” and “Program Design” values in the applicable fields.
  5. Clinical Affiliates Tab: List your current/existing clinical sites with current Clinical Instructor(s), where student competencies are evaluated.
  6. Use the full/formal name for each clinical site. Do not use nicknames or abbreviations.
  7. If any new clinical sites have been acquired since completion of the last annual report these sites must be added to the spreadsheet in order to be recognized by CAAHEP. Required for each new site:

·  A copy of the completed/signed affiliation agreement

·  Verification of clinical instructor credentials

·  The appropriate fee (www.jrcdms.org/fees.htm). Refer to policy 704 & 705 of the JRC-DMS Policies & Procedures for additional information

  1. Enter the credential number(s) for each Clinical Instructor in the indicated columns
  2. For any new Clinical Instructors added or changed at any clinical site, provide credential verification
  3. In the last column under Change Y/Add/Delete indicate the changes as described:

·  “DELETE” Clinical Affiliate Site: Enter the word DELETE after the Clinical Affiliate Site

·  “ADD” Clinical Affiliate Site: Enter the word ADD in the last column

·  “Y” to note changes to or within the Clinical Affiliate Site: Site name change, new CI, CI name change, etc. Enter a Y in the column and briefly indicate the changes (i.e., Y-CI name change, Y-remove CI)

  1. Outcomes Tab: Enter your outcomes for all students who graduated in the specified year (this will be the year prior to the AR due date).

a.  Programs are required to provide a link (URL) to the website page containing outcomes for Attrition, Job Placement and Credential Success Rates. Be sure the most current data appears on your program’s web page.

b.  Do not delete or remove previous action plan(s)

  1. Save your spreadsheet, titling it ProgramName201X AR. Example: UniversityofAmerica2016AR.xls
  2. Send the AR, the new clinical site affiliation agreement(s) and verification of new or changed Clinical Instructor credentials via e-mail to .

JRC-DMS Annual Report Instructions (Updated 3-2017)