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Preceptor evaluation form 2026
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- Click ‘Get Form’ to open the preceptor evaluation form in the editor.
- Begin by entering your name in the 'Intern Name' field, followed by your preceptor's name and license number.
- Fill in the 'Paramedic Program' and the dates for when your internship began and ended.
- For each rating question, select your response using the provided scale from 'Strongly Agree' to 'Strongly Disagree'.
- In the 'Overall Ratings' section, rate your preceptor and various components of the course using the scale from 'Excellent' to 'Very Poor'.
- Use additional pages if necessary to provide comments for any ratings that are below expectations.
- Finally, sign and date the form at the bottom before submitting it to the San Joaquin County EMS Agency.
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preceptor evaluation form
Created April 2020. CON Undergraduate Programs Undergraduate Program Documents Clinical Evaluation Forms Student Evaluation of Preceptor-Mentor.Read more
The applicant above completed a minimum of 40 hours of assessment and evaluation under my supervision, which began on and ended on.Read more