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Click ‘Get Form’ to open the Preceptor Data Form in the editor.
Begin by entering the student's name in the designated field at the top of the form.
In section 1, provide your name, current position, and years in that position. Fill in your agency or school details as well as your basic nursing education program information, including degree and graduation date.
For section 2, list your current specialty certification along with the certifying agency and validity period. Remember to attach a copy of your School Nurse certificate.
In section 3, describe your expertise in the relevant area. Attach your current resume or curriculum vitae for reference.
Complete section 4 by providing your state of licensure, license number, and expiration date. Finally, indicate whether you are willing for other Rutgers students to contact you for future precepted experiences by selecting YES or NO.

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What are the 7 roles of preceptors?

Identifies and mutually agrees the learning opportunities that will facilitate the achievement of the learning outcomes and challenge the student to assume responsibility for their own learning. Orientates the student into the policies and structure of the practice environment.

What is the role of a preceptor in healthcare?

The Ulrich Precepting Model identified 7 roles of preceptors: role model, teacher/coach, facilitator, protector, socialization agent, leader/influencer, and evaluator (Figure 1).