HIV-Hepatitis Expert/ACTHIV

Preceptorship Application

Click here to download more information about ACTHIV STEP HIV Preceptorships

To apply for the preceptorship, or to get more information, please complete the following:

Your information:
Name:
Email address:
Telephone number:
Which site is of interest?
Additional Information
Profession:
State (2 letter abbreviation) and Professional License:
What dates are preferred? (please submit up to 3 requested dates)
Why do you want to participate in this learning experience?
 

You should receive an email within a week after we check the requested dates with the preceptor. Thanks for your interest.

Join us in Dallas April 20-22, 2017 ACTHIV