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Practicum Application - Preceptor
*
indicates a required field.
Preceptor Information
First Name:
*
Last Name:
*
Title:
*
Department:
Highest Degree Earned:
*
BA
BS
DrPH
DVM
EDD
JD
LLM
MA
MD
MHSA
MLS
MPA
MPH
MS
MSN
MSW
NP
PA
PhD
RN
ScD
Year of Degree:
*
Field (If necessary):
Years of Public Health experience:
*
Certifications:
Phone Number:
*
Fax Number:
Email Address:
*
Confirm Email Address:
*
I am a GW graduate.
Graduation Year:
Degree:
Department/Track Preference:
*
Environmental and Occupation Health
Epidemiology/Biostatistics
Global Health
Health Policy
Prevention and Community Health
Health Services Management & Leadership
Do you have a limited service faculty appointment at GWU?
Yes
Have you previously served as an SPHHS Site Preceptor?
Yes
Are you an employee of the organization where the practicum will be conducted? (Not a volunteer, for example)
*
Yes
Alternate Contact
First Name:
*
Last Name:
*
Title:
Department:
Phone Number:
*
Fax Number:
Email Address:
*
Confirm Email Address:
*
Professional Profile
Please paste a copy of your professional profile/resume here.
*
Include years of public health and health related experience and skills gained during eduation, including dates.
Please do not submit URLs.
Primary Professional Areas or Services
Homeless health
Hygiene and sanitation
Immigrant and refugee health
Immunizations
Infant mortality
Infectious diseases
Injury/injury prevention
Interventions (e.g. design, delivery)
Long-term care
Maternal health
Medicare/Medicaid
Mental health
Minority health
Nutrition
Obesity
Occupational health
Physical activity and exercise
Population health
Referral for health services
Reproductive/perinatal health
School health
Sexually transmitted diseases/infections
Social services
Substance use/alcoholism
Surveillance (e.g. disease)
Tobacco Control
Tuberculosis
Violence/violence prevention
Workforce development
Women's health
Aging and senior services
Adolescent health
Asthma
Bioterrorism
Cancer
Cardiovascular health
Child health (pre-adolescent)
Chronic diseases
Community health
Community organizing
Dental health
Diabetes
Emergency preparedness
Environmental health
Epidemiological investigation
Evaluation (e.g. interventions, health services)
Family health
Family planning
Family violence
Gay, lesbian, and transgender health
Global health
Health communications/marketing
Health disparities
Health education/outreach
Health finance
Health IT
Health policy
Health promotion
Health regulation
HIV/AIDS
site maintained by
James Kraetz
| last updated 22 November 2009 |
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