Thank you so much for your interest in serving as a preceptor for the South Carolina College of Pharmacy!

* 1. Current Contact Information

* 2. Email address

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

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

* 6. Preceptor Information

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