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* 1. Name of School/University

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* 2. Program of Study

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* 3. Select Cone Health Campus

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* 4. What Department were you on?

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* 5. Preceptor Name

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* 6. The staff members are welcoming.

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* 7. The nursing staff members were supportive in helping me learn.

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* 8. The staff work well together and create a good working environment.

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* 9. Based on this experience, I would consider being a Cone Health employee.

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* 10. This experience helped me meet my course objectives.

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* 11. State anything that could be done to make this a more valuable learning experience.

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* 12. Identify any staff member by name you would like to recognize as contributing ‘above and beyond’ to your clinical experience.

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* 13. Please feel free to use this space to provide any open-ended feedback regarding your experience conducting your clinical rotation with Cone Health.

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