PreceptorsSchool of NursingThe University of Texas at Austin 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your First Name, Last Name, and Middle Initial in the designated fields.
3. Fill in your Credentials and indicate if you have precepted a University of Texas School of Nursing student prior to this semester by selecting 'Yes' or 'No'.
4. Provide the Site Name and complete the Site Mailing Address fields accurately.
5. Indicate the Unit and whether the site serves Medicaid or underserved patients.
6. Complete contact information including Agency Contact Person, Nurse Manager, Office Phone, Cell Phone, Home Phone, and Home Address.
7. Enter your E-mail Address and re-enter it for confirmation. Fill out Practice Specialties and Experiences Available by checking applicable boxes.
8. Provide Licensure Info including License # and Expiration Date. Indicate your Highest Degree Earned by checking the appropriate box.
9. Add any Preceptor Comments in the provided section and specify Semester/Year of Preceptorship along with Student Name(s) and Course #/Name.
10. Finally, review all entries for accuracy before signing the Preceptor agreement at the end of the document.

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