Thank you for supervising one of our Medical Preceptor students. Students receive a pass/no pass grade when registered for the preceptorship program. As part of the student's evaluation, we are soliciting your comments on his or her performance. Please select the appropriate number in the categories listed below. In addition to being part of their grade, your evaluation is included in the student's pre-med folder for future use. Please feel free to include any additional comments. Students may request access to the top portion of this evaluation.

If you would like to print this form out to mail back to us, please click here.

Please rank the student in the following areas, with 1 being low and 5 being high

Please provide us with any additional comments on any outstanding attributes or abilities, areas of improvement, recommendations for further development, or any other relevant items not included above.

The following assessment is confidential

Please rate this student's suitability for a career in this profession, based on your impression. Please select one of the following