Get For Interested Community Preceptors 2013 -form.pdf

Filling out the For Interested Community Preceptors 2013 -Form.pdf online is a straightforward process designed to facilitate your participation in the Family Medicine Interest Programs. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the form smoothly.

1. Click the 'Get Form' button to download the form and open it in your chosen PDF editor.
2. Begin by filling in the personal information section. Provide your name, current practice name, and physical address. Ensure all details are accurate for effective communication.
3. Next, indicate your preferred mailing address if it differs from your physical address, and add your contact phone number and email address.
4. In the educational and faculty development information section, answer whether you currently serve as a family medicine preceptor. If you have precepted before, share the medical schools you have accepted students from and your experience level with first-year and third-year medical students.
5. Continue to the practice information section, checking all relevant boxes regarding the demographics of your practice. Note the geographical location of your practice as well.
6. Detail any innovative activities your practice offers that serve as teaching aids and note if your practice is recognized as a Patient-Centered Medical Home.
7. Indicate whether your practice uses electronic health records technology and list any special healthcare interests you may have.
8. In the final sections, specify your interest in student placements, any previous commitments, and additional comments. Attach a copy of your curriculum vitae as required.
9. Once you have completed all fields, review your information for accuracy. Save your changes to retain the completed form.
10. Finally, you can download, print, or share the form as needed, and submit it according to the provided instructions.

Complete your form online today to share your expertise with future medical professionals.