Preceptor Evaluation of Student 2022 Question Title * 1. Student Name: Question Title * 2. Community: Altona Beausejour Brandon Carman Community Health Centre Churchill Crystal City (Rock Lake) Dauphin Flin Flon Garden Hill Gillam Gladstone Glenboro Grandview Hamiota Lac Du Bonnet Little Grand Rapids Morden Morris Neepawa Niverville Norway House Notre Dame Poplar River Portage Rankin Inlet Rivers Russell Sanikiluaq Selkirk Souris St. Pierre St. Thereasa Point Ste. Anne Ste. Rose Steinbach Family Medical Stonewall Swan River Thompson Treherne Virden Vita Wasagamak/RSL Winkler Other (please specify) Question Title * 3. Preceptor: Next