The Palmetto Experiential Education Partnership is a collaboration between the Medical University of South Carolina and University of South Carolina Colleges of Pharmacy.

At the end of this form you will be prompted to upload your current CV or resume. 

Thank you so much for your interest in serving as a preceptor for our pharmacy students!

Current Contact Information

Question Title

* 1. Current Contact Information

Email address

Question Title

* 2. Email address

Date of Birth (MM/DD/YYYY)
This information is collected to eliminate duplicate accounts within the rotation management system. 

Question Title

* 3. Date of Birth (MM/DD/YYYY)
This information is collected to eliminate duplicate accounts within the rotation management system. 

Please select the most appropriate answer to identify your current status as a SCCP preceptor.

Question Title

* 5. Please select the most appropriate answer to identify your current status as a SCCP preceptor.

Preceptor Information

Question Title

* 6. Preceptor Information

If you are a pharmacist, do you CURRENTLY have any of the following  additional degrees or certifications?

Question Title

* 10. If you are a pharmacist, do you CURRENTLY have any of the following  additional degrees or certifications?

T