Gab-Nic Excelsior Nursing Tutoring Center

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LPN Nursing Tutoring Questionnaire


1. What school did/do you attend?


2. How many years did you attend?


3. What grade level are you?    

        

4. Are you going to sit for your exam? If yes when?


5. Is this your first time taking the exam?


6. Did you receive a diagnostic of which subjects you are strong and week? (If so please bring it on your next meeting)


7. What do you expect from this tutoring session?


8. What subjects are you weakest in?


9. Do you prefer to be tutored alone or in a group?


10. What is your level of English?


11. How many hours a day can you study?


12. What resources/materials have you used in the past. (Please bring them on your next meeting)


13. What is your studying method?


14. Are you a visual or audio learner?

LPN Tutoring Rule and Regulations


  1. I am a Christian and believe that if God is not helping both of us we will accomplish nothing.
  2. I am your tutor not a teacher.
  3. I am very serious about my work. I may seem strict but it is for your own benefit.
  4. You must be honest with yourself and me. Following all given instruction.
  5. I do not allow tape recordings of my sessions.
  6. You must be able to put aside two hours for every hour of tutoring.
  7. My tutoring sessions are not simply directed at succeeding a test but succeeding a career.
  8. You must accept your lack and allow me to help you fill them, in order to grasp the essential parts of what you need to learn. That may entail starting at basic anatomy and physiology or medical surgical nursing review and not NCLEX review.
  9. You must pay attention and be able to participate. (That implies you taking notes asking question and answering questions that I pose)
  10. There will be a final assessment test at the end of the tutoring sessions to evaluate your progress and your readiness for future exam(s).
  11. I will offer studying materials for your benefit and expect that you review them. (added fee for print outs)
  12. I will give quizzes as I see fit, before or after tutoring session in order to ensure that we are on the same page.
  13. I may provide you with review questions after a couple tutoring session to ensure you are retaining the materials covered.
  14. An attendance sheet will be signed on each meeting.
  15. Schedules are subject to change for both parties.
  16. I will be doing a written evaluation on your progress after each session.
  17. If you will be unable to attend a tutoring session a 24-hour notice is required.
  18. Please call if you are to be late.
  19. A (few) basic test(s) may be given at the first tutoring session to evaluate your standing and denote how much tutoring will be necessary how long and where we shall start. (Your study plan will be personalized to your needs.)
  20. Payment must be received before tutoring is done over the phone. No speaker phone used during session.
  21. Your study plan will be my personally designed 6-13-step method where you will be encouraged to read, listen, watch and practice. 
  22. The price for the LPN tutoring is as indicated on page 3; if you are able to bring 2 people I will reduce the price by $10 dollars. 
  23. I require an additional one-time fee of $15 dollars for the use of my study plan.


I, ______________________________________, have carefully read and agreeto comply with the rules and regulations of this tutoring

                                    (Print Name)


program to comply with the rules and regulations of this tutoring program.


Name:_________________________________  Date: __________________

                                            (Sign name)

LPN Excelsior Nursing Tutor Disclaimers


In view that you have: (please note the checked item)


o failed the final assessment test, 

o not fully followed the 6-13 step plan, 

o willfully decline assistance to fill your lacks( i.e. review of anatomy and physiology, systematic review of medical surgical content),

o refused to be openly evaluated with a verbal or written quiz 

o not played an active role in the tutoring cessions with your participation (i.e. note taking, asking question, answering of questions asked)

o denied any lack of understanding of material presented 

o refused any added material to you course of study 

o refused to pay your due balance,

as  per contract, we hereby 

o relinquish all responsibility for any failure that you may face in your future exam(s). 

o terminate your tutoring sessions until the time that you pay the full amount of the balance due, totaling $________________.

                         

Name:_______________________________ Date: ________________

                                   (Tutee Signature)

Name: _______________________________ Date:________________             

                                   (Tutor Signature)

Name: _______________________________ Date:______________

                                   (Witness Signature)


Disclaimer


I, _________________________, agree that if under the tutelage of the nursing tutor Mr./Ms. ________________________________ at Excelsior Nursing Tutor

o I failed the final assessment test,

o I did not fully followed the 13 step plan, 

o I willfully decline assistance to fill your lacks( i.e. review of anatomy and physiology, systematic review of medical surgical content etc..),

o I refused to be openly evaluated with a verbal or written quiz 

o I did not not played an active role in the tutoring cessions with my participation (i.e. take notes, asking question, answer questions asked, use studying recourses provided)

o I denied any lack of understanding of material presented 

o I refused any added material to my course of study 

o I refused to pay my due balance, of said amount

as  per contract, I may be required to terminate the tutoring sessions until further notice and will be responsible for any failure that I may face on my future exam(s)

                          Name:_______________________________ Date: ________________

                                                            (Tutee Signature)

                          Name: _______________________________ Date:________________             

                                                            (Tutor Signature)

                           Name: _______________________________ Date:________________

                                                            (Witness Signature)