South Carolina HIV/AIDS Clinical Training Center Request for Preceptorship Form

Tell Us About Yourself
* indicates a required field

* First Name: * Last Name:  
* Profession:
Please provide the mailing address of the health care facility at which you are employed.
* Name of Facility:
Street: City:  
State: Zip Code:  
* HIV Training topics of particular interest to you (e.g. adherence, HIV 101)
Contact Information
* E-Mail Address: Telephone:  
Fax: Pager:  

Locations for Preceptorship

Preceptorships typically take place at the USC Immunology Center Clinic in Columbia.
Financial support for travel may be available.

For more information on the South Carolina HIV/AIDS Clinical Training Center, Preceptorships, or other clinical needs, contact our Program Coordinator at (803) 545-5402 or Adrena.Harrison@uscmed.sc.edu

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