Verifying preceptor hours

Re-certifying and verifying preceptor hours

The UW School of Nursing will provide verification of hours of preceptorship. This information can be used to complete the preceptorship verification forms, a requirement for re-certification by the American Nurses Credentialing Center and other organizations.

Forms and documentation

Many commonly used forms and details related to the documentation needed by certifying bodies is below:

Send the completed form

Please provide the completed form to the appropriate coordinator below:




Adult-Gerontology Nurse Practitioner Pam Barney
Family Nurse Practitioner Kristine Takamiya
Nurse-Midwifery & Women’s Health Clinical Nurse Specialist Clare Sherley
Pediatric Nurse Practitioner & Pediatric Clinical Nurse Specialist Sarah Agtarap
Population Health Nursing Jenny Tsai
Psychiatric Mental Health Nurse Practitioner Anita Souza

Remember to include instructions for returning the form to you. Please note that many certifying bodies will need the original document; faxes are not accepted.