Clinical Participation Requirements

Clinical / Practicum Placements

• Overview
• Process for Initiating Clinical Affiliation Agreements

Preceptor Selection
Site Requirements
Credit and clock hour requirements for clinical courses by concentration
FNP Concentration Required Clinical Hours
Preceptor Appointment Agreement
Clinical / Practicum Course Registration Requirements
Responsibilities in the Preceptor Partnership

• Student Responsibilites
• Concentration Coordinator / Faculty Responsibilites
• Contact Liason
• Preceptor Responsibilities

Preceptor Forms

• Intent of Relationship Form (DOC) (PDF)
• Preceptor Information Form (PDF)
• Preceptor's Professional Profile Form (PDF)
  
  Preceptor forms should be faxed to Lori Stephens at (615) 366-3953 at least 8 weeks before the beginning of the semester. Students are requested to keep a copy of all forms for their records and may be asked to upload copies into their course(s) at the beginning of each semester. Please do not have the preceptor submit the
  forms on your behalf.
  
  For questions and assistance regarding clinical/practicum placement, please
  contact Lori Stephens at lori.stephens@tbr.edu.
  

Physical Examination Form - SAMPLE (PDF)
Health History Form - SAMPLE (PDF)

Clinical Forms

• Clinical Log (PDF)
• Clinical Skills Inventory (PDF)
• Clinical Performance Evaluation Form (PDF)
• Preceptor Evaluation of Student Form - Informatics (PDF)
• Preceptor Evaluation of Student Form - Education (PDF)

Program Evaluation Forms

• Student Evaluation of Preceptor / Site Form (PDF)