North Florida AIDS Education and Training Center A Partner of the SE AETC Network

Preceptorship Application Form

North Florida AETC preceptorships are an intensive clinical training program offered to healthcare providers in Florida who have an interest in learning more about the diagnosis and management of HIV/AIDS, opportunistic infections, and co-morbid conditions. Preceptorships provide extensive clinical training and supervised experiences in urban and rural clinics throughout the region, and are available for physicians, dentists, nurses, nurse practitioners, physician assistants and pharmacists.

Each preceptorship and clinical training experience is structured to meet the unique needs of the individual participant based on his or her previous experience, geographic location, and time available.

All training provided is consistent with current guidelines from the Department of Health and Human Services (DHHS) or other nationally recognized guidelines when available.

Preceptorship Application

Name(Required)

First Last

Work Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Best Phone Number:(Required)

Email(Required)

What is your preferred method of contact?

My professional discipline is best described as:(Required)

Select all HIV/AIDS-related topics you have encountered in your work(Required)

Treatment Adherence

Antiretroviral Treatment

Clinical Manifestations of HIV Disease

Co-Morbidities

Hepatitis A, B, C

Opportunistic Infections

Viral Resistance

Risk Reduction

Select all the HIV/AIDS related topics that you would like to learn about during your preceptorship experience(Required)