Get Preceptor Application Form Pdf - Sjfc

The Preceptor Application Form Pdf - Sjfc is an essential document for individuals who wish to become preceptors at the Wegmans School of Pharmacy. This guide will provide clear, step-by-step instructions for filling out the form online, ensuring a smooth and effective application process.

Follow the steps to successfully complete your preceptor application form.

1. Press the ‘Get Form’ button to obtain the Preceptor Application Form Pdf - Sjfc and open it in your preferred online editor.
2. Fill in your date at the top of the form, followed by your last name and first name. This personal identification is crucial for processing your application.
3. Provide your business phone, FAX number, pager number, cell/alternate phone, preferred email address, and an alternate email address to ensure clear communication.
4. Enter your practice site name along with the practice site (store) number, if applicable. Fill out the practice site address, city, state, and ZIP code.
5. Indicate the number of years you have been in pharmacy practice or in a pharmacy-related position, along with the type of practice you are involved in (e.g., patient care, non-patient care, elective).
6. Detail your education by providing the college/university/program name, dates attended, and the degree awarded.
7. Mention your state licensure details including the state, license number, and whether the license is active or inactive.
8. If applicable, provide information regarding your post-graduate training such as the program name and dates attended.
9. List any certifications you may hold, followed by your work history, which includes position held, organization, and dates.
10. Answer the questions regarding internet access, your experience as a preceptor for other schools, and whether you provide a work/study area for students.
11. Indicate your willingness to serve as a mentor for students and specify the types of rotations (introductory or advanced) you are willing to precept.
12. Provide descriptive information about your practice site to inform students about their potential rotation experiences.
13. Specify personnel with whom the student will interact by checking relevant options on the form.
14. Once all fields are completed, you can save changes, download the completed form, print a copy for your records, or share it as needed.
15. Submit your completed application form along with your CV to Debbie Favro via email at dfavro@sjfc.edu or by fax at (585) 385-5295.

Complete your Preceptor Application Form Pdf - Sjfc online today to support the future pharmacists at the Wegmans School of Pharmacy.