Clinical Preceptor Agreement Sample Contracts
CLINICAL PRECEPTOR AGREEMENTClinical Preceptor Agreement • July 12th, 2021
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in Oregon. If more than one preceptor will be involved in supervising the student, a separate form is required for approval.
CLINICAL PRECEPTOR AGREEMENT (revised 08/07/19)Clinical Preceptor Agreement • August 9th, 2019
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in Oregon. If more than one preceptor will be involved in supervising the student, a separate form is required.
Clinical Preceptor Letter of AgreementClinical Preceptor Agreement • October 23rd, 2019
Online program. I will provide opportunities for this student to observe me in my role, provide direct supervision of the student during performance of any procedures as needed, provide feedback to the student regarding clinical performance, and complete the evaluation tools and return them to the course instructor by specified due dates.
CLINICAL PRECEPTOR AGREEMENT For Non-Oregon Based Programs Offering Advanced Practice Clinical Experience in Oregon (Revised 07/01/2021) InstructionsClinical Preceptor Agreement • February 23rd, 2022
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in Oregon. If more than one preceptor will be involved in supervising the student, a separate form is required.
All forms must be submitted to OSBN by the educational institution. CLINICAL PRECEPTOR AGREEMENT (revised 11/06/14) For Non-Oregon Based Programs Offering Advanced Practice Clinical Experience in Oregon InstructionsClinical Preceptor Agreement • January 28th, 2022
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in Oregon. If more than one preceptor will be involved in supervising the student, a separate form is required.
CLINICAL PRECEPTOR AGREEMENTClinical Preceptor Agreement • July 12th, 2021
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in Oregon. If more than one preceptor will be involved in supervising the student, a separate form is required.
Clinical Preceptor Letter of AgreementClinical Preceptor Agreement • December 15th, 2021
Online program. I will provide opportunities for this student to observe me in my role, provide direct supervision of the student during performance of any procedures as needed, provide feedback to the student regarding clinical performance, and complete the evaluation tools and return them to the course instructor by specified due dates.
State of New HampshireClinical Preceptor Agreement • May 8th, 2020
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in New Hampshire. If more than one preceptor will be involved in supervising the student, a separate form is needed for each. The form(s) must be completed and attached to the Petition for Non-New Hampshire Based Programs Offering Clinical Experience in New Hampshire which must be submitted a minimum of three weeks prior to the start of the clinical experience. All forms must be submitted to the NHBON by the educational institution. Email board.questions@oplc.nh.gov
CLINICAL PRECEPTOR AGREEMENT (revised 08/07/19)Clinical Preceptor Agreement • August 9th, 2019
This form is to provide contact information and signatures of the designated preceptor and supervising faculty for each student completing clinicals in Oregon. If more than one preceptor will be involved in supervising the student, a separate form is required.