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Section 3.02.01: Student Release of Information and Student Understanding of Field Expectations Agreement

Each student signs the following when they submit their online placement request forms.

Release of Information

As a part of the field placement assignment process, the OFE will need to share student placement materials and other relevant information with potential field sites and field instructors. This includes discussions with the prospective field instructor, sending a copy of the student's goal statement, resume, student agreement, and prior placement evaluations if applicable/requested. These materials enhance the matching process which generally benefits the student and the field instructor. Without a written release, the Office of Field Education is unable to provide the field site with the information required to make a determination regarding the student's field placement. This release also covers all collaboration between the field site and the Office of Field Education/School of Social Work after the placement has been confirmed.

I hereby give my permission to the Office of Field Education, School of Social Work at the University of Michigan, to release any and all information included in my application for field placement to potential field sites and field instructors for the purposes of arranging field placement(s). This release extends to several field sites when necessary for confirmation of a mutually agreeable placement site. This release does not apply to my application materials to the School of Social Work, personal references, or transcripts. My signature on this agreement indicates that I have read and understand this agreement and represents that I meet and agree to all criteria listed above.

I have read this Participation Agreement and I understand and agree with it.


Student Understanding of Field Expectations Agreement

Each student signs the following when they submit their online placement request forms.

I understand and agree, in accordance with the curriculum requirements outlined in the School of Social Work Student Guide that in order to complete the social work program in which I am enrolled, I will be required to complete a field placement. Students will have placement opportunities that match their primary pathway.

I understand as a student in the online program that field placement options may be limited by my location. OFE will work with students to develop field sites in the students home area (ideally within a one-hour drive from the students home) if a field site has not previously been established. I understand that I am responsible for my own transportation and that the University of Michigan and/or the School of Social Work is not responsible for my travel to and from my field placement.

I understand that as a condition of my field placement, I am required at my own expense, to consent to, complete and pass any or all field site required background checks such as criminal, child-elder abuse, driving record, sex offender, substance use testing etc. I understand that my background check results may influence my placement options and my future ability to become licensed.

I understand and will comply with all regulations related to the Health Insurance Portability and Accountability Act (HIPAA) as enacted by the field site where I am placed.

If I am an interpersonal practice student, I understand that "clinical" placements are defined in a multitude of ways and few field sites offer training in learning how to do long term psychotherapy.

I understand I may complete interviews at potential field sites. If more than two (2) field placement sites do not make an offer, I will need to meet with the assistant dean for field education and/or the Student Success Team to discuss this.

I understand and agree that while I am in field placement, I am not covered by workman's compensation for any accident/injury that may occur during my time at the field site doing field placement related business. I understand that I, or my medical insurance plan, are responsible for all expenses incurred while I am working in my field placement and that the University of Michigan and the University of Michigan School of Social Work assume no responsibility or liability for any injury I might sustain. Therefore, I specifically release the University of Michigan, its schools, departments, agencies, officers, directors, and employees from any such responsibility or liability.

Any student seeking accommodations is encouraged to contact the Office of Services for Students with Disabilities at the beginning of the term (
https://ssd.umich.edu/ ). This office assists students in negotiating disability-related barriers to the pursuit of their education.

I understand and agree to this Student Understanding of Field Expectations Agreement.

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