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 Student and Term Information  

 
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This is either a practice manager, executive assistant, secretary, etc. that communicates information directly to your preceptor. If you have provided direct contact information for your preceptor, this can be skipped.
 
   
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This is extremely important as we will communicate paperwork, rotation requirements, and so on directly with your preceptor or their contact person via email. If you would like to provide multiple emails, please separate emails with a semicolon(;).
 
   
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If you are going to have multiple preceptors within the same semester, please SUBMIT A NEW SURVEY for that preceptor and allot the hours accordingly.
 
   
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If you are unsure if your site is an Atrium site, visit their https://atriumhealth.org/ and click their Locations tab to search your site. 
 
   
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