SCHOOL OF NURSING BETTY WHITE HEALTH CENTER
Graduate Nursing Program
Adult-Gerontology Primary Care DNP Program
Clinical Practicum Preceptor
LETTER OF NOTIFICATION AND APPRECIATION
The purpose of this letter is to thank ___ for providing learning (Agency)
opportunities for ___ who is enrolled in ___ at (Student)
Kentucky State University. The learning experience will begin on _____ and end _____ (Beginning Date).
(Ending Date)
___
Student Signature Date
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Student Name – Typed
___
KSU Representative Date
___
KSU Representative – Typed
___
Preceptor Date
___
Preceptor Name – Type
___
Appropriate Agency Official Date
___
Appropriate Agency Official – Typed
Address:
T11
Telephone:
Email:
Address:
Telephone:
Email:
Address:
Telephone:
Email:
Address:
Telephone:
Email: