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Preceptor Registration
Name
(Required)
First
Last
Email
(Required)
Password
(Required)
Enter Password
Confirm Password
Clinical Site
(Required)
Who will be receiving the stipend for completion of this toolkit?
(Required)
Please indicate whether you or your organization will be receiving payment and provide a mailing address so that this payment can be sent.
Send payment to me
Send payment to my organization
Disclaimer:
By creating an account and participating in Le Moyne’s Preceptor Development Toolkit, participants understand that the Le Moyne College Department of Physician Assistant Studies (DPAS) must follow HRSA guidelines and budgetary restrictions in order to process stipends. To receive stipend payment, The Le Moyne College PA Department will first need to verify your eligibility; if your status as an active preceptor has not yet been verified, you may not be eligible to receive payment. Payment is contingent upon completing modules by June 30, 2024, and is subject to funding availability.
For the purposes of the Preceptor Development Toolkit, an active preceptor is defined as follows:
1. A provider who is listed as a preceptor in Le Moyne’s student placement management system (EXXAT); and
2. Is located at a site with a current affiliation agreement with the Le Moyne College PA Program; and
3. Has precepted at least one Le Moyne College PA student within 18 months prior to completing the PDT or, for new preceptors, is scheduled to precept at least one student for a rotation prior to June 30, 2024.
Affirmation
(Required)
I understand I may not be eligible to receive payment if my status as an active preceptor is not verified and that payment is subject to change based on registrations and funding for this grant.
(Required)
If you are not an active preceptor but are interested in becoming one visit
lemoyne.edu/preceptor
to learn more.
Enter the email address where you will be receiving payment.
Enter your organization’s address.
Payment Mailing Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code