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Sunday May 19 , 2013

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The Journal of Trauma Nursing is the only peer reviewed journal dedicated to trauma nursing. It is the official publication of the Society of Trauma Nursing.

STN Request for Mentor Application

First Name

Last Name

Credentials

Preferred Email address

Preferred phone number

STN Member

Yes No

How many years have you been a member?

Title

Employer

City

State

Trauma Center Level

ACS Verified

Yes No

State Designated

Yes No

Years of experience in trauma

How many verification site visits have you led?

How many consultation visits have you led?

How many focus visits have you led?

Have you been a site reviewer for the ACS or State Designation?

Yes No

For what area of trauma care/program do you need a mentor? (check all that apply):

Leadership Program Management Program Administration Program Coordinator Trauma Registry Management Injury Prevention Performance Improvement Research Education Preparation for Site Visit Finance Other

If Other, please define:

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