CDIP Preceptor Testimonial Form

College to Career Diversity Internship Program (CDIP)
2021 College to Career Diversity Internship Program participants

This web form is designed to capture the impact CDIP interns have had on HASC member hospitals, as well as document program milestones. The information you submit will enrich future HASC communications about the program. Please fill out the form and upload your photo by Friday, Oct. 21, 2022. If you have trouble uploading photos or want to submit additional information, please email to HASC Digital Communications Specialist Mark Changco, mchangco@hasc.org. Thank you!

CDIP Preceptor Testimonial Form

Step 1 of 3

Preceptor name(Required)