Employee Warning Notice

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)

N/A

Completed Set Coursework for Semester?

/ ☐ / ☐ / ☐ /

2.GPA Adequate?

☐

Met Required Research Goals?

/ ☐ / ☐ / ☐ /

4.Passed Qualifying Exam?

☐

Written

☐

Oral

☐

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