Clinical Preceptorship — Trinity Family Medical Clinic

Clinical Preceptorship

We accept ARNP/DNP, PA, MA, and other medical students for clinical rotations. If you would like to have one of our providers be your preceptor, please fill out the form below. We will contact you to inform you of whether one of our providers is available to precept or not after reviewing your information.

Name

First Name

Last Name

Phone

(###)

###

####

Email

Preferred Method of Contact

What School Do You Attend?

What Year Are You In Your Program?

How Many Clinical Rotations Have You Completed?

Please include the name of the specialties (e.g., Family Medicine, Dermatology, Urgent Care ,Neurology, etc.)

What Are the Dates of Your Rotation?

How Many Hours Do You Need to Complete?

How Many Days Per Week Can You Be On-Site?

Are There Any Other Requirements of Your Clinical Rotation We Need to Know About?