TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement 2019 free printable template
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PRECEPTORS HIP / CLERKSHIP AGREEMENT by and betweenness AGREEMENT, made this date, (university)(student)and Peninsula Regional Medical Center in patient care areas including these special areas: (check
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How to fill out TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement
01
Obtain a copy of the TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement form from the relevant department or website.
02
Fill in your personal information, including your name, address, contact details, and academic background.
03
Provide details about the preceptorship or clerkship program, including the duration, location, and specific focus areas.
04
Include the names and contact information of your preceptors or supervising faculty members.
05
Specify the responsibilities and expectations for both you and your preceptors during the program.
06
Review the agreement thoroughly to ensure all information is accurate and complete.
07
Sign and date the agreement at the designated section.
08
Submit the completed agreement to the appropriate department or office as instructed.
Who needs TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement?
01
Students pursuing a clinical rotation or practical training in healthcare fields.
02
Educational institutions that require formal agreements for student placements.
03
Healthcare professionals seeking structured supervision during preceptorship or clerkship experiences.
04
Organizations that facilitate or oversee clinical training programs.
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What is TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement?
The TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement is a formal document that outlines the terms and conditions under which students in healthcare training programs can gain clinical experience at TidalHealth Peninsula Regional medical facilities.
Who is required to file TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement?
Students enrolled in healthcare education programs who intend to complete their clinical training at TidalHealth Peninsula Regional are required to file the Preceptorship/Clerkship Agreement.
How to fill out TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement?
To fill out the TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement, students must complete all required sections of the form with accurate personal and academic information, and submit the agreement along with any necessary documentation to the designated administrative office at TidalHealth.
What is the purpose of TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement?
The purpose of the TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement is to establish a legal understanding of the expectations, responsibilities, and scope of practice for both students and TidalHealth during the clinical training period.
What information must be reported on TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement?
The information that must be reported on the TidalHealth Peninsula Regional Preceptorship/Clerkship Agreement includes the student’s personal details, educational background, program specifics, start and end dates of the preceptorship or clerkship, and any relevant disciplinary or health-related disclosures.
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