UTRGV preceptor agreement and clinical forms

Q: Does my preceptor get a copy of the course objectives?

Yes. NURS 6612 makes the objectives part of the preceptor agreement, and UTRGV's Clinical Request Form says the student presents the course objectives once the facility agreement is authorized. Texas rules also expect written objectives to reach the preceptor before the experience starts. Bring the objectives for the specific course, since each clinical course has its own.

Updated September 27, 2026 · Reviewed by the UTRGV Preceptor placement team

Every UTRGV preceptorship runs on a short stack of paper: a preceptor agreement with a student commitment, an orientation packet for the preceptor, a weekly time report, evaluations in both directions and, for PMHNP students, a letter verifying hours. The forms themselves sit in Brightspace rather than on the public website, but the syllabi say what each one is for and when it is due.

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1 weekbefore clinical: signed agreement and time report due in NURS 6347

30-90days for a new affiliation agreement, separate from the preceptor agreement

Numbered steps. How we keep your paperwork moving: 1 Preceptor details up front; 2 Agreement signed early; 3 A schedule you can report; 4 End-of-course follow-through. — How we keep your paperwork moving: 1 Preceptor details up front; 2 Agreement signed early; 3 A schedule you can report; 4 End-of-course follow-through.

The forms at a glance

UTRGV's syllabi name the required clinical forms. The Spring 2026 NURS 6613 syllabus has the fullest FNP list, the Fall 2025 NURS 6476 syllabus covers the PMHNP uploads, and the Spring 2026 NURS 8512 syllabus covers the DNP. Titles shift a little from course to course; the table uses the most common wording.

UTRGV clinical forms, their purpose and timing
Form	What it does	Who completes it	When it is due
Preceptor Agreement Form and Preceptor Agreement-Student Commitment	Puts the preceptorship and the course objectives in writing	You and your preceptor	After the site is approved, at least a week before clinical
Preceptor Orientation Packet	Explains the preceptor role and the UTRGV experience	You hand it to the preceptor	Before any clinical experience begins
Mandatory Weekly Time Report (FNP)	Tells faculty where and when you will be in clinic	You	With the agreement, then weekly (every Wednesday class in `NURS 6612`)
Typhon preceptor data sheet (NP, PA or physician)	Records a preceptor's credentials	You, with your preceptor's details	When adding a preceptor new to UTRGV; PMHNP Week 1; DNP by Week 2 of `NURS 8512`
Evaluations: of you by preceptor and faculty; of preceptor and site by you	Feeds your clinical grade and rates the placement	Preceptor, faculty and you	End of the course
Letter Verification of Clinical Clock Hours Preceptor (PMHNP)	Confirms your supervised hours	Your preceptor, started by you	When the clinical experience ends
Student liability insurance	Shows coverage for patient contact	You	Each academic year; the policy renews September 1

The preceptor agreement and the student commitment

The preceptor agreement is the written arrangement between you, your preceptor and UTRGV for a single course. The Fall 2025 NURS 6612 syllabus makes sharing the course objectives with your preceptor part of that agreement, and the FNP forms list pairs it with a student commitment form. DNP students file the same pair by Week 2 of NURS 8512.

Timing follows approval. In NURS 6347, the signed, scanned agreement goes in once the course coordinator has approved your sites and no later than a week before your first scheduled clinical day. In NURS 6305, it goes to your assigned lab instructor a week ahead. A late agreement delays your start, and with 224 or 336 hours to fit into a semester, lost weeks are hard to win back.

Texas rules expect this kind of paper. 22 TAC §219.10 calls for written agreements that spell out each party's duties, and for clinical objectives to reach the preceptor ahead of the experience.

The preceptor agreement is not the affiliation agreement. The affiliation agreement is between UTRGV and the facility, requested through the Clinical Request Form, and UTRGV's form says clinical practice begins once that facility agreement is authorized. A signed preceptor agreement at an unaffiliated site does not get you started.

The preceptor orientation packet

UTRGV's archived 2023-24 graduate guide describes a School of Nursing Preceptor Orientation Packet that sets out the preceptor role and the clinical experience, and it required that each preceptor receive the packet before any clinical work begins. The packet is not published; it lives with the course forms in Brightspace.

Treat it as part of start-up, not an afterthought. A preceptor who has taught students from other schools still needs UTRGV's version, because the agreement they sign and the evaluations they complete are UTRGV's own. When our placement desk lines up a preceptor, we brief them on what a UTRGV preceptorship involves, so the packet you hand over reaches someone who is already expecting it. Questions the packet leaves open go to your course coordinator or clinical faculty, who stay responsible for your clinical learning.

The Mandatory Weekly Time Report

This FNP form keeps faculty informed of your schedule. The Fall 2025 NURS 6612 syllabus has you turn it in every Wednesday class, covering the current week and the one after, because faculty make random site visits and use the report to find you. In NURS 6347, the first report goes in with the signed agreement, a week before clinical.

Read the report as a commitment about where you will be. If a clinic day moves, update the report and tell your clinical faculty, since the FNP syllabi expect absences to be reported to all of them. How visits work is on the site visits and evaluations page.

The time report is separate from your hour log. Logs need your preceptor's signature every week, and under the NURS 6612 grading criteria a log without those signatures, or without a preceptor evaluation, is not accepted. The rules for counting hours cover the rest.

Data sheets for a preceptor new to UTRGV

When your preceptor is not already on UTRGV's list, the forms list in the Spring 2026 NURS 6613 syllabus gathers the paperwork for a preceptor or site new to UTRGV under one heading. It holds three Typhon data sheets, one each for nurse practitioners, physician assistants and physicians, plus the DocuSign version of the Clinical Request Form. The data sheet captures who the preceptor is; the request form starts the facility agreement.

PMHNP students upload a preceptor data sheet during Week 1 of NURS 6476, after all parties have signed, as part of the pre-clinical paperwork their clinical faculty reviews before clearing them. DNP students file a data sheet for a physician or DNP-prepared APRN by Week 2 of NURS 8512. The Typhon guide covers the system itself.

Evaluations and the PMHNP hours letter

Each clinical course closes with evaluations running both ways: your preceptor and your faculty assess you, and you assess the preceptor and the site. FNP, PMHNP and DNP courses all use a version of this set, and the FNP syllabi list these evaluations among the required clinical forms, not optional surveys.

PMHNP students have one more document. The archived 2023-24 guide says the student starts the verification of supervised hours when the clinical experience ends, using the Letter Verification of Clinical Clock Hours Preceptor kept in the PMHNP Toolbox. The guide places that toolbox in Blackboard, which Brightspace replaced in Summer 2025. Have it ready for your preceptor on your last shift, while the hours are fresh for both of you.

Insurance proof and the other before-day-one items

Student liability insurance appears on the Spring 2026 FNP list of required clinical forms, named for the 2025-2026 year. The catalog requires the coverage for any course with patient contact and bills it with fall registration, and the archived guide says the policy renews every September 1.

Keep the current year's certificate with your clinical documents, since the FNP forms list names the policy by academic year and a site may ask to see it. Students returning after a break also resubmit their documentation, insurance included, under the School of Nursing's readmission policy.

Two more items come before any clinical hour: a HIPAA training certificate, completed in Brightspace, and the Statement of Confidentiality printed in every syllabus, which you sign before your first rotation. Background checks and immunizations are in the compliance checklist.

How we keep your paperwork moving

Preceptor details up frontWhen a preceptor agrees, we collect the license, certification and practice details the data sheet and the Clinical Request Form ask for, so nothing waits on a callback.
Agreement signed earlyWe walk the preceptor through the agreement and the student commitment and aim to have both signed well ahead of the one-week line.
A schedule you can reportWe set a clinic schedule with the preceptor that you can put on the weekly time report with confidence.
End-of-course follow-throughWe remind the preceptor about the evaluation and, for PMHNP students, the hours letter before the rotation closes.

Your course faculty review and approve each form. Our part is making sure each one arrives complete and on time. Tell us your course and dates.

Questions UTRGV students ask

Where do I find the UTRGV preceptor agreement form?

Inside your course in Brightspace (D2L). Several syllabi still point to a forms tab under the older Blackboard name, since UTRGV switched systems in Summer 2025. The agreement is not posted on UTRGV's public website, so if a course does not show it, ask your course coordinator or clinical faculty which folder holds the current version.

Does my preceptor sign a new agreement for each UTRGV course?

Plan on it. Each clinical syllabus lists its own agreement among the required forms, and NURS 6612 ties the agreement to that course's objectives, so a preceptor who carries you from NURS 6612 into NURS 6613 should expect fresh paperwork. Ask your course coordinator whether anything signed earlier can carry over.

Does my preceptor get a copy of the course objectives?

Yes. NURS 6612 makes the objectives part of the preceptor agreement, and UTRGV's Clinical Request Form says the student presents the course objectives once the facility agreement is authorized. Texas rules also expect written objectives to reach the preceptor before the experience starts. Bring the objectives for the specific course, since each clinical course has its own.

Do UTRGV PMHNP students file the Mandatory Weekly Time Report?

The report appears in the FNP syllabi. PMHNP students work from the paperwork their clinical faculty sets: the Week 1 pre-clinical forms in NURS 6476, including the signed data sheet, Typhon logs that faculty and preceptors can review, the end-of-course evaluations and the hours letter. Ask your clinical faculty whether a schedule report is expected too.

What if my preceptor is late with the end-of-course evaluation?

It can hold up your course, because the FNP syllabi make a satisfactory clinical preceptorship grade a condition of passing and the preceptor's written evaluation is part of how you are assessed. Hand the form over early, agree on a date, and tell your clinical faculty promptly if it slips.

UTRGV systemClinical Request FormHow UTRGV's Clinical Request Form sets up a new clinical site: the fields, standard and non-standard agreements, the 30 to 90 day wait, and who does what.UTRGV systemPreceptor requirementsWho may precept each UTRGV course: NPs, PAs or physicians for FNP, two NPs for NURS 6347, ABPN or ANCC board certification for PMHNP, and the DNP rule.TyphonTyphonHow UTRGV nurse practitioner students use Typhon: one purchase for the MSN, logging hours and encounters, preceptor data sheets, signed logs and who sees them.UTRGV systemSite visits and evaluationsHow UTRGV faculty oversee clinicals: random FNP site visits, remote PMHNP oversight, evaluation forms both ways, and what it takes to pass a clinical course.UTRGV systemPlacement processEvery published step of UTRGV clinical placement for FNP and PMHNP students, from buying Typhon and picking a site to the preceptor agreement and final forms.ComplianceCompliance checklistWhat UTRGV asks of NP and DNP students before clinicals: background check, immunization form, liability insurance, site onboarding and what is not published.

Last checked 2026-09-27

We check these pages against UTRGV's own catalog, course syllabi, School of Nursing pages and Texas Board of Nursing rules. Your course faculty and the School of Nursing have the final word.

From the approved list or a brand-new site, we find the preceptor who fits.

Tell us your UTRGV program, where you live and when your next clinical course starts. We line up a willing preceptor who fits the course and UTRGV's rules, and hand you the details the Clinical Request Form, the affiliation agreement and the preceptor agreement ask for, well before the semester.

Family practice preceptors for NURS 6612 and NURS 6613, and two NP sites for NURS 6347
Board-certified psychiatric preceptors for NURS 6476 and NURS 6620, in your home state
Across the Valley and Texas, from McAllen and Brownsville to San Antonio, Houston and beyond
A replacement lined up fast if a preceptor drops

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