Wisconsin Department of Corrections
Available Sites
- All DOC prison facilities
None
Requirements/Restrictions
Employees only: No
CV/Resume/Cover Letter: No
How to Find A Preceptor
Do not contact potential preceptors. The agency will assign someone.
Placement deadlines are flexible, but first come first served
Student Responsibility: Submit Preceptor Request Form
Clinical Placement Responsibility: Submit formal request through email
Required Information Upon Approval of Placement
Student will receive emails from the Department of Corrections staff or Clinical Placement Coordinator
• Background Check Authorization Form (1098D) - Complete, sign, date
• Student Placement Form (0310) – Complete, sign, date; I sign and date
• Nursing Student Acknowledgement Form (3771) – Complete, sign, date; Dean of Nursing sign and date
• Fingerprint form (1098T) – Complete, sign, date
• PREA Sexual Abuse and Sexual Harassment in Confinement (2786) – Review, sign, date
• Read Executive Directives 16, 35, 72, 80, and POC 0054 for PREA
• Emergency Contact Form (0762) – complete, sign, date
• DAI Volunteer Application (2674) – complete, sign, date
• HIPAA Employee Statement of Acknowledgement (3492) – review, sign and date
Last modified: Thursday, January 30, 2025, 10:23 AM