NCAHEC Community Primary Care Rotation Application
To: Greensboro AHEC Student Services
1200 N Elm Street, Greensboro, NC 27401

Terry Lynn, Director, Medical Education – 336-832-7933 |
Tonya Crawford Baldwin, MA, Student Services – Coordinator. 336-832-8566 |

All housing requests must be completed online at A Housing Agreement Form and a $50 security deposit are required. View for details and payment instructions. Deposit forfeited for no-shows or without 72-hour cancellation. Counties served: Alamance, Caswell, Chatham, Guilford, Montgomery, Orange, Randolph, Rockingham
  • Please complete the following information.

  • / /
  • - -
  • (if placement has not been scheduled)
  • - -
  • - -
  • Student/Course Information

    I verify that this student is in good standing with the University, has completed all pertinent OSHA training, and is covered for liabitility during this community rotation.
  • Placement Information

    We request that the AHEC/Student Services office assist with this student placement.
  • We have tentatively scheduled the above student with the following preceptor:
  • - -
  • AHEC Housing

  • If YES, students must complete the online AHEC Student Housing Application at