Preceptor Training Acknowledgement Form

Select ALL institutions for which you provide precepting services:
I agree to perform the duties bestowed on me as a healthcare student preceptor. I further attest that I have met the qualifications to be a healthcare student preceptor and have completed the required preceptor training.
Typing your full name here signifies that you are completing this form using an electronic signature. By signing electronically, you are certifying that you have read and understand the Disclosure/Consent and agree to electronically sign. You also agree to receive required disclosures or other communications related to this transaction electronically.