The BSM program has been updated.

All students enrolling as of 2013 may NOT use the forms on this page.

If you enrolled in 2013 or later, click here to go to the updated program



BSM Program (pre-2013)


Evaluation Forms must be printed out, signed and dated, and sent with the end-of-trimester submission to NCM by mail.

OLD PROGRAM Evaluation Forms for students enrolled prior to 2013 Description

(OLD)BSM Student-Preceptor Evaluation Form

This form is required at the end of each trimester in which the student was active. An evaluation form must be completed with each preceptor with whom the student worked during that trimester and must accompany any other work the student turns in.
Credit Value Assessment Form Course Credit Value Assessment - Did the amount of time needed for the student to complete each course meet the time requirement stated on the syllabus?
Services & Policies Evaluation Form Complete this if you have any recommendations for NCM Services & Policies
Curriculum Evaluation & Review Form Complete this if you have any recommendations for the NCM courses you have worked on with your student.
Information Change Form Complete this if there are any changes to your contact info, name, etc.
Suggestions or Comments Form Complete this if you have additional comments or suggestions.

Academic Prerequisites can be completed prior to, or concurrently with enrollment in BSM:

Course Syllabi Word Version Adobe Acrobat Version   Test Key Credits
MOD1-MATH112G-Fundamental Math
.doc .pdf   N/A N/A
MOD2-ENG200G-Analytical Writing
.doc .pdf   N/A N/A
.doc .pdf   Test Key
MOD8-HON220G-Midwifery Literature & Art
.doc .pdf   N/A N/A



BSM 10 Mentored Births:

(24 Credits)

BSM-MW480-10 MENTORED BIRTHS Adobe Acrobat Version Credits
BSM MW480 Syllabus
BSM MW480 Instructions for Documentation  
BSM MW480-A: Chart Review Checklist  
BSM MW480-B: Record of Chart Review Objectives  
BSM MW480-C: Summary of Completed Chart Reviews  

Senior Thesis Based on Clinical Research Project:

(15 Credits)

Outline of the Research Review Process
Research Guidelines
Research Project Proposal Checklist
Research Thesis Checklist
Research Project Proposal /Thesis Draft Approval Request Form
Additional Resources:
Charter for Ethical Research
Federal Policy on the Protection of Human Subjects
The Health Insurance Portability and Accountability Act (HIPAA)
Informed Consent Form
MLA Formatting & Style Guidelines (requires internet connection)
How to write a thesis (requires internet connection)
NCM Highly Recommends completing an online course on how to write a scientific research paper, such as the one at: