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Evaluation of preceptor example

Preceptor evaluation form 2026

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The document is an evaluation form for the Preceptor/Paramedic Program by the San Joaquin County Emergency Medical Services Agency. It is designed for paramedic interns to assess their preceptors based on various criteria, including guidance, knowledge, and overall effectiveness in preparing them for a paramedic role. The form includes rating scales and space for comments, aiming to gather feedback on the internship experience and the paramedic program.

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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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Versions	Form popularity	Fillable & printable
2012	4.8 Satisfied (198 Votes)
2011	4 Satisfied (24 Votes)

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