Agreement to Precept

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University of Arkansas at Monticello
School of Nursing

CONTRACT AGREEMENT TO PRECEPT

The agreement made this

day of

, year of

between the University of Arkansas at Monticello (UAM)

School of Nursing and

(Practicum Preceptor) witnessed that:

Whereas, the contracting parties are desirous of cooperation to furnish practicum education to students of nursing enrolled in the

NURS

course at UAM, it is mutually agreed that:

1. The Practicum Preceptor will provide learning experiences necessary for the student to achieve personal and practicum

objectives of the

contact-hour practicum experiences as a requirement for passing the course.

2. The practicum Preceptor will assume responsibility for instruction and supervision of the student during the practicum hours established by the preceptor.

3. The Practicum Preceptor will provide feedback regarding student performance by completing the UAM Preceptor Feedback of Student Performance form.

4. A UAM faculty member shall be available for consultation at all times while the student is involved in the practicum experience.

Preceptor:

Witness:

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