Raven EMS Education Program Manual
Preceptor and Clinical Evaluation by Students Form

Preceptor and clinical evaluations are to be completed by students after each clinical experience, field experience, and field internship.

Results of this evaluation, including the comments, will be available to preceptors and faculty. The identity of the student submitting this evaluation will not be available to preceptors.

Clinical date:

Location Name:
Location Evaluation Strongly Agree Agree Neutral Disagree Strongly Disagree
This location was a good clinical location.
Please provide your anonymous comments about the location here:
Preceptor Name:
Preceptor Evaluation Strongly Agree Agree Neutral Disagree Strongly Disagree
This preceptor was a good preceptor.
Please provide your anonymous comments about the preceptor here:

Change Log (3.85.250.PCES)

DateAuthorDescription of ChangeCitations
2023-12-13Becker, T.Theron Jack BeckerCreated this form.
2025-01-02Becker, T.Theron Jack BeckerMoved online from Adobe InDesign document.
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Raven EMS Education Manual - Table of Contents
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