Student Application

Step 3: Request Your Preceptor Doctor

"*" indicates required fields

Confirm your @college.lifewest email

Email*

This field should pre-populate with your @college.lifewest email and ensures you are correctly connected in our system with the Preceptor Doctor you list below. In almost all cases, this should not be edited. If this does not appear to be the case, please email the Preceptor Program Administrator.

Designate Your Preceptor Doctor

Important: The expectation is that you have spoken with the DC, you've established a good fit and that you've mutually agreed to move forward with a preceptorship.

Preceptor DC - First Name*

Preceptor DC - Last Name*

Preceptor DC - Email*

Preceptor DC - Phone*

Preceptor DC - Website URL

Preceptor DC - Practice/Office Name*

Preceptor DC - Office Street Address*

Preceptor DC - Office City*

Office State/Province*

Office Postal/Zip Code*

Preceptor DC - Office Country

Students

Next Steps & Application Status

Waiting for Data Sync

Step 1: Tell us about you

Submit this as soon as you register for an account.

Status: Not Received

Step 2: Find Your Preceptor Doctor

Students looking for a Preceptor Doctor can begin their search using our filterable database of approved DCs here.

Step 3: Designate Your Preceptorship Doctor:

Submit once you and your Preceptor Doctor have mutually agreed to move forward.

Status: No DC Selected

Step 4: Sign the College Preceptor Agreement:

To begin the program, both you and your Preceptor Doctor must sign the College Preceptorship Agreement. This will be sent to all parties for e-signature via email once your requested DC has been approved.

Status: Sent once DC is requested and approved

If Applicable: Documentation Uploads

Typically, only required for external, non-Life West applicants. Internal applicants should skip this step unless specifically asked for additional documentation via email.

Status: No documentation currently required

If Applicable: Student Program Fee

Only required for external, non-Life West applicants. Internal applicants should skip this step unless specifically asked for via email due to extenuating circumstances.

Status: No fee currently required