Typhon Site/Preceptor Request

注意：此页面上的信息适用于MSN＆BSN-DNP学生。DNP学生应该visit the Typhon DNP page for information specific to their program.

在填写此表格之前，请检查Typhon中的网站和主管目录，以查看是否已经列出了所需的选择。指向目录的链接可以在您的Typhon主页上的右侧列中找到。

When confirming status in the directory, please check foryour specific site。不要仅仅因为企业已经在系统中有另一个位置而选择您的网站在Typhon中。许多企业没有覆盖所有地点的合同，因此需要将任何新网站都要求为“不在Typhon”，以便我们可以验证承保范围。不正确选择此选项将导致处理您的请求的延迟。
If your site is in Typhon, please be sure your request form uses the site nameas it appears in Typhon.如果您的网站在目录中列出，但地址已更改，请选择该状态选项。

Please be sure you have accurate licensure information for your preceptor. Inaccurate or incomplete information will cause delays in processing your request
- If you are adding a preceptor, all fields in that section are required.
- 对于德克萨斯州护理许可证，请使用高级实践许可证号。它应该以“ AP”为开始，然后是6位数字。

Student Information

Student name

UTEmail address

选择您的程序：

选择您的专业：

Intended Start Date at Site:

Intended End Date at Site:

Expected Clinical Hours:

站点信息

I have logged into the Typhon system and verified the following:

站点名称：

临床部位的类型：

Street Address

City

State:

邮政编码

Site Telephone:

Site Fax:

站点联系：

Site Contact Email:

Site Administrator:

Administrator Email:

Preceptor Information

I have logged into the Typhon system and verified the following:

Typhon信息

Track Director:*(request will be delivered to your selection):

将此网站/官员添加到Typhon系统：

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