Quarterly report – preceptors | Colorado Rural Health Center

Certifier Report for Preceptor Tax Credit - to be filled out quarterly

Health professional program and school
Clinical coordinator Person Of Contact (POC)
POC e-mail address
Certification Questions
How many forms did you certify this quarter?
How many forms were ineligible this quarter?
How many active rural preceptors are working with your program?
Rotation yield this quarter from rural preceptors?
Additional rural rotations needed in this quarter?
Prior to 2019, how many of your alumni have been hired by your rural preceptors?
How many of your alumni have been hired by any rural provider?
Of these hires, how many of them have been hired by your rural preceptors this quarter?

Certification Questions