TCOM Preceptor Sign-Up Form
During TCOM 4th Year, students are responsible for coordinating their own rotations. Usually this gives students great freedom to personalize their path. However, during COVID-19 it has presented unforeseen challenges, as many sites are reducing or eliminating medical students from their operations. If you are willing to accept TCOM Students for a clinical rotation in the 2020-2021 academic year, please complete the form below. Any questions may be directed to ConnerReynolds@my.unthsc.edu

TCOM Class of 2021 sincerely thanks you for any consideration!
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Name *
Email Address *
Phone Number
What is your preferred method for contact by students interested in a rotation? *
Required
If you answered 'Other' to the previous question, please let us know the best way for students to contact you
What is your medical specialty? *
Required
If you answered 'Other' to the previous question, please describe your medical specialty below
What city & state do you currently practice in? *
How would you describe the setting of your practice? *
During which of the following periods would you be willing to accept a 4th year TCOM student for rotations? *
Required
If you answered "Other" to the previous question, please provide the dates you'd be open to having 4th year TCOM students rotate with your practice
During COVID-19, some preceptors/sites have elected to provide virtual rotations in their specialty. This rotation structure is entirely at the preceptors' discretion. some example activities include regularly scheduled physician-led didactic session over Zoom, student presentations, online modules, Case Files assignments, and research projects.  Would you be interested in hosting virtual rotations for TCOM students in your specialty? *
Please provide any preferences that you have for TCOM Students rotating with you
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