SHOW Health Fair 2017 Health Professional Preceptor Registration Form
***THIS FORM IS ONLY FOR LICENSED HEALTH PROFESSIONALS.***

Health professional preceptors will be assigned a booth or zone to assist and mentor the health professional student volunteers. Health professional students will be assigned into interprofessional teams as much as possible.

SHOW Health Fair 2017
Saturday, October 21st, 2017
10:00am - 2:00pm
Lodestar Day Resource Center
1125 W Jackson St, Phoenix, AZ 85007
Name *
Your answer
Email *
Your answer
Phone Number *
Your answer
Preferred Shift *
Have you volunteered with SHOW in the past? *
Health Professional Discipline *
Level of Licensure *
Your answer
University or Organization Affiliation *
Booth Requests
If you would like to work at a particular health assessment booth or have a suggestion for a booth, please submit it here. To see a list of booths, click here: https://docs.google.com/spreadsheets/d/1EFKgG07kroR0_p_x9wtM9BWBtztSFw1dn-3vzLk7W-0/edit?usp=sharing
Your answer
Questions?
Your answer
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