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Paramedic Preceptor Acknowledgment & Information
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First Name
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Your answer
Last Name
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Your answer
Phone Number
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Your answer
Email
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Your answer
License
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EMT-P
RN
What is your EMT-P or RN License Number?
Your answer
Agency?
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Note:
I have reviewed the preceptor training packet provided by Lane Community College and have the qualifications to precept both EMT and Paramedic students.
I hereby attest that the above information is true and accurate to the best of knowledge.
Digital Acknowledgement Signature
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Your answer
For questions please contact:
Darrek Mullins, EMT/Paramedic Clinical Coordinator
Cell: 541-954-1237
Email:
MullinsD@lanecc.edu
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