The EKU preceptor information form and your other clinical documents
Before each clinical course, EKU's MSN and post-MSN students keep a set of documents current, and the one that carries your preceptor is the "Clinical contract and preceptor information form". This guide works from the 2021-22 MSN Student Handbook, an edition EKU no longer posts, so check every item against the current handbook your program provides. DNP students use a separate site approval request.
Get your preceptor details ready
Tell us your EKU program and your next clinical course. Your placement advisor finds a preceptor who fits and gathers what EKU's form needs.
Where this list comes from
EKU's program pages point students to an MSN Student Handbook without linking one, and the FNP page still names the 2020-2021 edition. The latest edition anyone can read is the 2021-22 handbook, revised May 1, 2022, and it is available only through archived copies. Its cover carries a November 2020 revision date while the 2020-21 edition says November 2021, so the two dates appear to have been swapped.
The handbook covers MSN and post-MSN certificate students alike, which matches the catalog rule that all MSN policies apply to certificate students. Read everything below as what EKU asked for in 2021-22, then confirm the current version with your faculty or program coordinator before relying on it. Where the current catalog and the handbook differ, as they do on NSC 800 credits, the catalog governs.
The documents at a glance
Each document the archived handbooks name is listed here with who it applies to and what it covers in general terms. EKU does not publish the forms themselves, so their individual fields are not public.
| Document | Who | What it covers |
|---|---|---|
| Clinical contract and preceptor information form | MSN and post-MSN, FNP and PMHNP | Your preceptor and site for the course, and the contract behind the placement; kept current for NSC 800, NSC 876 and NSC 886 |
| Clinical Waiver form | MSN and post-MSN | Named in the handbook; contents not public |
| Telehealth Checklist | FNP students in NSC 800 and NSC 876 | Telehealth clinical experiences; contents not public |
| Site-specific documents | All clinical students | "Other documentation and/or requirements as specific to the clinical site" |
| Unencumbered RN license | All clinical students | An unencumbered RN license for every state where you are licensed |
| Professional liability insurance | All clinical students | Coverage purchased through EKU, with the receipt shown to faculty before clinical experiences |
| Nursys e-Notify | MSN students, at admission | Consent to enroll in license monitoring |
| Request for DNP Experience Site Approval Form | DNP students | One request per clinical course; the Clinical Placement Coordinator emails approval to begin |
| DNP Experience Log | DNP students | Date, time and nature of each learning activity and its link to the DNP Essentials |
The clinical contract and preceptor information form
This is the document where your input becomes part of EKU's record. The 2021-22 handbook listed it as item 4 of the required documentation for clinical courses, to be kept up to date and shown every enrolled semester ahead of clinical work. Its two-part name tells you what it joins: the preceptor who will teach you and the contract that lets you train at the site.
EKU has not published the form, so its exact fields are not public. Going by its name and its place in the handbook, it records who your preceptor is, where the site is and which clinical course the placement serves, and connects that preceptor to the agreement the site needs. Having that substance ready before the form reaches you is what keeps it moving.
Two related rules from the same handbook are worth knowing. If your RN license is ever disciplined, you must notify your academic advisor and the Clinical Coordinator immediately. And the attendance section calls the preceptor "the clinical instructor (preceptor)", so the person named on this form is someone you notify, along with your clinical faculty, before any missed clinical day.
Filing the form once is not enough. The handbook tied it to each clinical course and each semester of enrollment, so a new course, a new preceptor or a new site calls for an updated version.
Clinical Waiver, Telehealth Checklist and site documents
The Clinical Waiver form appears in the handbook's list without a description. Ask your faculty what it covers and when it is signed, rather than working from an old copy.
The Telehealth Checklist applied to FNP students in NSC 800 and NSC 876. EKU has not published its contents or said whether telehealth time counts toward the 750 direct patient care hours, so settle that with your faculty before building telehealth days into your schedule.
Site-specific documents are set by the clinical agency. EKU's catalog notes that collaborating organizations may add their own screening, background and fingerprint checks, immunization records and training certificates, all at the student's expense, and may refuse a placement when a criminal record or failed drug test turns up. The compliance requirements guide goes item by item.
License, Nursys e-Notify and insurance
Your license sits beneath every other document. The handbook asked for an unencumbered RN license in all states where you hold one, and students consented at admission to Nursys e-Notify, a license monitoring service. Every license counts: a restriction in one state matters even if you train in another. The license and Nursys page explains both, including licensing in the state where you train.
Insurance is the other gatekeeper. Professional liability insurance had to be bought through EKU rather than an outside carrier, its coverage followed an August-to-August year, and faculty had to see the receipt before students could take part in clinical experiences. Put the purchase on your calendar with your first clinical term so it never holds up day one.
DNP students: the site approval request
EKU's DNP Student Handbook (revised June 9, 2020, archived) replaces the MSN form with its own. Each clinical course calls for a fresh "Request for DNP Experience Site Approval Form", and a student may begin DNP Experience Hours only after an approval email from the School of Nursing Clinical Placement Coordinator. After onboarding at a site, a student can mark a later request as continuing at that site.
The same handbook keeps hours from counting until the semester has begun and onboarding is finished, and pairs each approval with a DNP Experience Log of dates, times and activities. Ask the DNP program whether these 2020 forms are still the ones in use. The catalog's 1,000-hour post-BSN total and the hours owed at EKU are explained on the DNP clinical hours page.
How we prepare your preceptor details
A form is only as good as the information behind it. Your placement advisor gathers the preceptor's credentials and license record, confirms the specialty fits your EKU course, and collects the site's own screening and contract needs early, so what you enter for EKU is accurate and complete the first time. For DNP students we prepare the same substance for the site approval request.
We also watch the calendar for you. Each new clinical course or site means an updated form, so we have the next preceptor's details ready before the term turns over, and a preceptor who leaves mid-term is replaced with the new paperwork prepared alongside. The decision on each preceptor stays with EKU; our part is making sure it has everything it needs. Start with the form below.
Questions EKU students ask
Where do I get EKU's preceptor information form?
EKU does not post the form publicly. It comes through your program: ask your clinical faculty or program coordinator, and check the current MSN Student Handbook, which enrolled students receive. The archived 2021-22 handbook names the form without showing its contents, so an old copy found online will not tell you what the current version asks.
Do I need a new preceptor form if my preceptor changes?
Plan on it. The handbook required the form to be kept current, and a new preceptor or site is exactly the change that makes an older version out of date. Tell your clinical faculty as soon as you know, because EKU's approval of the new preceptor comes before your clinical time with them.
Is the Telehealth Checklist required for PMHNP students?
The 2021-22 handbook listed the Telehealth Checklist for FNP students in NSC 800 and NSC 876 only, and said nothing about PMHNP courses. Whether that has changed, and whether telehealth time counts toward clinical hours in either track, is not public. If your preceptor sees patients by video, ask your faculty before you plan around it.
What does the "clinical contract" in the form's name refer to?
EKU does not define it publicly, but the name ties your preceptor details to the agreement a site needs before hosting you. EKU's public contract rules are few: for Missouri, EKU notes that only short-term site contracts are allowed. The agency agreements guide covers what is known.
Do DNP students fill out the MSN preceptor form?
Not under the archived handbooks. The DNP handbook has its own site approval request, one per clinical course, signed off by the Clinical Placement Coordinator, plus a DNP Experience Log. It also asks DNP students to display EKU photo identification at every clinical site. Confirm the current forms with the DNP program.
Related pages
Last checked 2026-09-25
We check these pages against EKU's own catalog, program pages and handbooks, and Kentucky's regulations. The current MSN Student Handbook, your course and your faculty have the final word.
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NSC 800andNSC 876, psychiatric care forNSC 886 - Preceptor, license and site details organized for EKU's preceptor information form
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