Due to the unprecedented COVID-19 pandemic, the risk the disease presents to individuals and community, and the Universities’ obligation to protect all members of the campus community, the University requires preceptor doctors and interns understand, stay up-to-date on, and follow, the COVID-19 mitigation and infection control measures for health care workers established by the “Local Health Authority” which is either the Johnson County, Kansas Department of Health and Environment, or the local county and state health department where the preceptor doctor’s practice is located. These measures may include medical screening, social distancing, use of personal protective equipment, and increased disinfection protocols. Both preceptor doctor and intern acknowledge that they have read the guidance of the Local Health Authority and will rigorously follow it throughout the intern’s preceptorship. The preceptor doctor agrees to report to the CUKC Director of the Preceptorship Program any reported COVID-19 positive infection case that occurs in preceptorship office personnel or patients, from the period 14 calendar days before the start of the preceptorship, until 14 calendar days after the preceptorship. By signing below, I confirm that I have read, and accept, the above requirements.