Preceptor Agreement - must be signed before you start your retail clinical

If you are a Kaiser employee - disregard this information. 

This is a requirement for all other certificate students. 

Print this form, fill out the top portion, sign and date the second page. Then have your retail clinical site fill out their part and sign it. This must be completed and turned back in to your instructor before you begin your retail rotation.  

Preceptor agreement JB 2023.doc Download Preceptor agreement JB 2023.doc