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Questions regarding these forms can be directed to Xiao Sheng at xus1@psu.edu or Khushi Patel at kbd5@psu.edu.

Advisement Forms

Nurse Practitioner Forms: Family and Adult Gerontology (Acute and Primary Care)

  • Instructions for Approving Student Evaluations
  • Penn State NP Preceptor Agreement Form
  • Preceptor Evaluation of Student Clinical Experience
  • Student, Preceptor, and Faculty Responsibilities
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  • Faculty Evaluation on Student Clinical Performance
  • Instructions for Approving Student Forms

Nurse Administrator and Nurse Educator Forms

  • Clinical/Practicum Site Affiliation Agreement Request Form
  • Clinical/Practicum Student Log
  • Mentor Evaluation of Student Clinical/Practicum Experience
  • Student Evaluation of Preceptor/Mentor
  • Student, Preceptor, and Faculty Responsibilities

D.N.P. Forms

  • Clinical/Practicum Site Affiliation Agreement Request Form
  • Clinical/Practicum Student Log
  • Mentor Evaluation of Student Clinical/Practicum Experience
  • Student Evaluation of Preceptor/Mentor
  • Student, Preceptor, and Faculty Responsibilities

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