Get Preceptor Form - Ohio Board Of Nursing - State Of Ohio

Completing the Preceptor Form for the Ohio Board of Nursing is an essential step for individuals looking to serve as preceptors in nursing education programs. This guide provides a detailed, step-by-step approach to successfully fill out the form online, ensuring that all necessary information is accurately submitted.

Follow the steps to successfully complete the Preceptor Form online.

1. Click ‘Get Form’ button to access the Preceptor Form and open it in your desired editing platform.
2. Begin filling out Section I by providing your preceptor name, date, facility/employer name, original nursing education program name, and graduation date. If you have additional degrees in nursing or related fields, include this information along with corresponding graduation dates.
3. List your nursing experience by detailing your years and months of experience as a Registered Nurse (RN) and Licensed Practical Nurse (LPN), if applicable.
4. Complete either Section II A or II B, or both. In Section II A, enter your name of specialty certification, certifying organization, and validity period of the certification. In Section II B, describe your competencies in the specific clinical practice area where you will serve as a preceptor.
5. In Section III, provide details regarding your licensure. Include the state of licensure, type of license (check the appropriate boxes for RN or LPN), license number, and expiration date.
6. Section IV asks for your employment information. Provide the employer's name, location, employment dates (month/year), and the unit or area of practice. You may also attach your current resume or curriculum vitae to demonstrate your qualifications.
7. Section V requires verification of your licensure documentation. Make sure to have the necessary documentation ready for submission, as it is essential for maintaining compliance with the education program.
8. Review Section VI, which outlines the Ohio Administrative Code (OAC) rules related to preceptor requirements. Familiarize yourself with the necessary qualifications to ensure compliance.
9. Finally, provide your signature to attest to the accuracy of the information submitted along with the date and your printed name.
10. Once the form is completely filled out, save the changes, and choose to download, print, or share the form as needed.

Start completing your Preceptor Form online today to ensure your role in nursing education.