Students
- Out-of-Program Rotation Request Form
- Special Studies Form (PHMY 539, APEX 424, APEX 428, APPC 490) (PDF, Word format)
- Preceptor of the Year Nomination Form
Student Liability Insurance
Insurance is provided by the Healthcare Providers Service Organization free with APhA-ASP membership in the fourth year beginning on May 1st. Additional paperwork is not required for the fourth year. Certificates of coverage are emailed to the APhA-ASP chapter advisor. There is a fee for coverage for first-, second-, and third-year students.
Forms for Specific Rotations
Food and Drug Administration
Giant
Kaiser Permanente
Malcolm Grow Medical Center
- Training Addendum
- Fingerprint/Background Check Instructions
- Fingerprint/Brackground Check Request Letter
MedStar Sites (Franklin Square Hospital, Good Samaritan Hospital, Harbor Hospital, Montgomery General Hospital, National Rehabilitation Hospital, St. Mary's Hospital, Union Memorial Hospital)
St. Joseph's Medical Center
VA Medical Center
Washington County Hospital
For New Preceptors
To become a preceptor, please complete an application, an affiliation agreement, and a site information survey. Please contact the ELP office to verify if an affiliation agreement and site survey are already in place.
