/

The University of Texas Health Science Center at San Antonio

Radiological Sciences Program

Student Review Form

Section 1: Academic Data (to be completed by Student)

Name:
Enter Name.
/
Semester of Entry:
Enter Semester
/
Current Semester:
Enter Current Semester
Expected Graduation Date:
Enter Expected Grad Date
/
# of Hrs Completed this Semester:
Enter semester Hours Completed.
Semester GPA:
Enter Semester GPA.
/
Total # of Hrs Completed:
Enter Semester GPA.
/
Current Overall GPA:

Enter Overall GPA.

Click on the picture below to upload a picture of your web-based grades.

Section 2: Achievements and Goals

Achievements this semester: /

Date Completed

1. / Click here to enter a date. /
2. / Click here to enter a date. /
3. / Click here to enter a date. /
4. / Click here to enter a date. /
5. / Click here to enter a date. /
6. / Click here to enter a date. /
7. / Click here to enter a date. /
8. / Click here to enter a date. /
9. / Click here to enter a date. /
10. / Click here to enter a date. /
Academic & Research Goals for Upcoming Semester:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Section 3: Coursework for Next Semester

Course #

/

Course Title

/

Instructor

/

Credit Hours

1. / Enter Course Number. / Enter Course Title. / Enter Instructor Name. / Enter Hours. /
2. / Enter Course Number. / Enter Course Title. / Enter Instructor Name. / Enter Hours. /
3. / Enter Course Number. / Enter Course Title. / Enter Instructor Name. / Enter Hours. /
4. / Enter Course Number. / Enter Course Title. / Enter Instructor Name. / Enter Hours. /
5. / Enter Course Number. / Enter Course Title. / Enter Instructor Name. / Enter Hours. /
6. / Enter Course Number. / Enter Course Title. / Enter Instructor Name. / Enter Hours. /
Total Credit Hours / Enter Total Hours. /

Section 4: Review of Student Progress (to be completed by Advisor)

Y

/

N

/

N/A

  1. Completed Set Coursework for Semester?
/ ☐ / ☐ / ☐ /

2.GPA Adequate?

/

/

/

/
  1. Met Required Research Goals?
/ ☐ / ☐ / ☐ /

4.Passed Qualifying Exam?

/

/

/

/

Written

/

/

/

/

Oral

/

/

/

/
  1. On Track for Graduation?
/ ☐ / ☐ / ☐ /

Section 5: Signatures

I hereby certify that both my advisor and I have met, and I understand the requirements for next semester that have been presented before me.

Student Signature / Date
I hereby certify that I have met with the student, and we have discussed the next semester’s requirements. I recommend that they have met the following status during the review process of the previous semester:
☐ / ACCEPTABLE / ☐ / NON-ACCEPTABLE
Print Name of Advisor
Advisor Signature / Date