AAFP National Conference of Family Medicine Residents and Medical Students, July 27-30 '05, Kansas City, MO
» Student Opportunities

Doctoring 1 Preceptorship - 2007-2008

Teaching Interest Form

Personal / Professional Information
  7. Preferred Method of Communication (please check all that apply)
  10. Faculty Appointment
Community-Based Preceptor
  1. Please check which day(s) you are available: If you are available more than one day, please rank your preference:
    Doctoring 1 Preceptor - 1st-Year Students - Afternoons
  2. Would you like to precept more than one student?
  3. If yes, please indicate how many students you wish to work with
    on the day(s) you are available:
  4. Do you prefer a female or male student? (please choose one)
Preceptor Site Information and Patient Profile
  3. Practice
  4. Specialty (if applicable)
    (ex: Sports Medicine, Geriatrics, Alternative Medicine, etc.)
  5. Afternoon Hours
  6. Patient Demographics
  7. Student Parking Availability