become a preceptor

If you are interested in becoming a preceptor for our program, fill out our preceptor application below. The Office of Experiential Education will contact you shortly with additional information. If you have any questions please contact Cynthia Fitzpatrick, 419-434-5462,

Preceptor Application

Certificates, Residency, other post-graduate training *
Certificates, Residency, other post-graduate training
Have you completed any preceptor-specific training or continuing education? *
Have you completed any preceptor-specific training or continuing education?
Practice Setting (select one) *
Practice Setting (select one)
I am interested in precepting *
I am interested in precepting
Please read each statement so you understand the expectations of the preceptor:

-The preceptor should be aware that his/her relationship with the student is one of student-teacher rather than employer-employee, or co-worker.

-The student-teacher relationship must be built on mutual respect, trust, communication and understanding.

-The preceptor is responsible for the professional and legal supervision of the student during the experience.

-The preceptor should instill in the student the principles of professional ethics.

-The student should be given a thorough orientation to the site early in the rotation to facilitate a smooth transition into the site and optimize the use of available resources.

-The preceptor should explain to the student his/her expectations, particularly in the areas of dress, conduct, scheduling of hours, and general characteristics of practice.

-The preceptor should afford the student the time and patience needed for an optimal learning experience.

-The preceptor should not assume the student's level of competence but should determine it by reviewing the student's profile, discussing previous experience with the student, and observing performance of basic skills.

-The preceptor should expose the student to all aspects of practice consistent with the student's ability, needs, and interests as determined by the preceptor and guided by the course syllabi.

-The preceptor, in consultation with the student should establish a mutually-agreeable schedule of students activities for the rotation. If the schedule includes experiences with other practitioners, the preceptor should clearly communicate with these individuals and make arrangements for introductions, time and place to meet.

-Criticism should be constructive and conveyed to the student privately whenever possible.

-The preceptor should familiarize all personnel with the experiential program objectives to avoid misunderstanding and confusion about the student's role during the rotation.

-The preceptor shall complete the evaluation materials required by the College in an accurate and objective manner. The preceptor shall review each evaluation with the student.
I am certifying that I have a current pharmacist or practice license that is in good standing with its respective board. I am certifying that all the information on this application is true to the best of my knowledge.
I agree to all the terms above *
I agree to all the terms above
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