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Manchester University Fort Wayne Campus Pharmacy Program Preceptor Application
Precepting can be defined as teaching others the art and science of pharmacy practice in a health care setting with the goal of developing competent practitioners. Preceptors assure that their students attain competency at the practice of pharmacy much in the same way that master craftsmen supervise apprentices in developing the skills of their trade.

Thank you for your interest in becoming a member of the Manchester University Pharmacy Program preceptor team.  Please provide the following details regarding your pharmacy experience and rotation opportunities. (Note that you will need a current copy of your CV or résumé to upload.)

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  Personal Information
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  Site Information
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  Contact Information
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  Required field I am a licensed Pharmacist.
  Required field If yes, my license is in good standing with the Board of Pharmacy in the following state(s):
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  Required field What types of experiential education pharmacy rotations can you provide? (Please check all that apply.)
  Professional Years 1 (P1) and 2 (P2)
  Professional Year 4 (P4)

  Required fieldWill students have opportunities for directly supervised, patient care interactions during rotations?

  Required fieldWill students have opportunities to interact with other healthcare professionals during rotations?

  Required fieldWhat specialties will your student be exposed to during rotations?
  (Please check all that apply.)

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