On an annual basis, we must submit reports to the Commonwealth of Massachusetts Board of Registration in Nursing (BORN). BORN requires we provide them information on our preceptors. To comply with their request, we need your assistance by completing the information below. Please return to your student who will submit it to the Regis Seminar Instructor by week three of the semester. Failure to submit will create a clinical warning.

BSN at the least is required by the BORN for overseeing. Please have the BSN overseeing the experience fill out this form (Nurse Manager/Clinical Educator if necessary.)

Educational Background

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