New Student Form

The Role of Nurse Practitioner Preceptors in Shaping the Future of Healthcare

Are you ready to find your new Preceptor today?

We are thrilled you’re here! Preceptor Connect simplified the process for you because we know what a headache it can be. You are now at the first step. After filling out this student form one of our coordinators will get in touch with you to start your process. Whether you are a Nurse Practitioner or a PA looking to start your rotations, we can help you find the Preceptor that is right for you.

Student Form

Fill the form below to get one step closer to your new preceptor

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First Name *

Last Name *

Email *

City of Residence *

State of Residence *

Phone *

University *

Expected Date of Graduation *

City of University *

State of University *

Select your field of study *

Please Specify *

Number of clinical hours needed *

Rotation Start Date *

What date do you want to start your clinical rotation?

Rotation Preference *

In Person
Telehealth
Hybrid
No preference

Please keep in mind that your university may not allow telehealth and/or hybrid. Be sure to confirm with your school

Estimated Rotation End Date *

Approximately what date will be the end of your rotation?

Are you willing to travel? *

Years of preceptor experience required *

1 year
2 years
More than 2 years
No requirement

Some schools require that your preceptor must have a certain amount of professional experience

How do you prefer we reach out to you? *

Call
Text
Email
No preference

Additional Comments

Please let us know if you have any additional comments or you'd like to clarify any of your responses

New Student Form

Are you ready to find your new Preceptor today?

Student Form

Fill the form below to get one step closer to your new preceptor

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