MedHub Support Ticket Please submit the support ticket below for MedHub Support MedHub PRECEPTOR PROFILE ADDITION REQUEST MedHub PRECEPTOR PROFILE ADDITION REQUEST Please provide the following information if you would like to request the addition of a preceptor's profile to MedHub. Your Name* First Last Your Email Address* If you have more than 2 Preceptor Profiles to request at one time, please use this template and upload below. If there is a "bu.edu" email address applicable for this preceptor, please provide. Preceptor preferred email address must be an institutional email (e.g. University, Hospital). Gmail, Yahoo, and similar personal email addresses will not be accepted.FileAccepted file types: xlsx, xls, Max. file size: 100 MB.How many preceptor profiles are you requesting?* 1 2 3 or more (file upload) Preceptor #1Preceptor Name* First Last Credential (ex. MD, NP, PA, PhD) Preceptor BU Email Address If there is a "bu.edu" email address applicable for this preceptor, please provide above Preceptor Preferred Institutional/Work Email Address* Preceptor email address must be an institutional email (e.g. University, Hospital). Gmail, Yahoo, and similar personal email addresses will not be accepted. Preceptor Rank*Resident EducatorAttendingClinical Rotation*Emergency Medicine Clerkship SelectiveFamily Medicine ClerkshipGeriatrics ClerkshipMedicine 1 ClerkshipNeurology ClerkshipObstetrics/Gynecology ClerkshipPediatrics ClerkshipPsychiatry ClerkshipRadiology Clerkship SelectiveSurgery ClerkshipAmbulatory Medicine - Clinical ElectiveSurgery Subspecialty – Clinical ElectiveOtherPlease select the Clinical Rotation you would like this preceptor to be available for.Clinical Rotation (Other) Location of Clinical Rotation* Please enter the Preceptor's clinical rotation site/location name.Preceptor #2Preceptor Name* First Last Credential (ex. MD, NP, PA, PhD) Preceptor BU Email Address Preceptor Preferred Institutional/Work Email Address* Preceptor Rank*Resident EducatorAttendingClinical Rotation*Emergency Medicine Clerkship SelectiveFamily Medicine ClerkshipGeriatrics ClerkshipMedicine 1 ClerkshipNeurology ClerkshipObstetrics/Gynecology ClerkshipPediatrics ClerkshipPsychiatry ClerkshipRadiology Clerkship SelectiveSurgery ClerkshipAmbulatory Medicine - Clinical ElectiveSurgery Subspecialty – Clinical ElectiveOtherPlease select the Clinical Rotation you would like this preceptor to be available for.Clinical Rotation (Other) Location of Clinical Rotation* Please enter the Preceptor's clinical rotation site/location name.Additional Information? SUBMIT A MedHub SUPPORT TICKET SUBMIT A MedHub SUPPORT TICKET Your Name* First Last Your Email Address* MedHub Support Need:*Please describe your MedHub Support Need in detail and include all relevant information. If necessary, please include Module/Course/Rotation name, Block, Site Name, and Student/Faculty Names & Faculty Rank (Resident Educator/Faculty).FileMax. file size: 100 MB.FileMax. file size: 100 MB.FileMax. file size: 100 MB. Please allow 3-5 business days for service requests to be processed and resolved.