DR 0366: Rural & Frontier Health Care Preceptor Credit (2024)
Colorado · Colorado DOR · Used for tax years 2024
Colorado Form DR 0366 documents eligibility for the 2024 Rural and Frontier Health-Care Preceptor Tax Credit of $1,000. It records the preceptor’s license and practice information, the number of eligible students mentored, and certification by an institution or regional Area Heal
Who files this form
Complete and submit DR 0366 if you meet the preceptor requirements and provided a qualifying preceptorship to an eligible health professional student during tax year 2024.
To qualify, you must:
- Practice in a primary health-care field in a rural or frontier area.
- Provide an uncompensated mentoring experience with personalized instruction, training, and supervision.
- Provide a preceptorship lasting at least four working weeks or twenty business days during the tax year. The weeks or days do not have to be consecutive.
- Teach students enrolled at an accredited Colorado institution of higher education who are seeking an eligible degree or certification in a primary health-care field.
You must hold one of these Colorado licenses or certificates:
- Doctor of Medicine
- Doctor of Osteopathic Medicine
- Advanced Practice Nurse
- Physician Assistant
- Doctor of Dental Surgery
- Doctor of Dental Medicine
- Registered Nurse
- Registered Dental Hygienist
- Pharmacist
- Licensed Clinical or Counseling Psychologist
- Licensed Clinical Social Worker
- Licensed Professional Counselor
- Licensed Marriage and Family Therapist
- Psychiatric Nurse Specialist
- Licensed Addiction Counselor
- Certified Addiction Counselor Working in an Outpatient Clinical Setting
What you'll need
Have the following information ready to complete DR 0366:
- Your SSN or ITIN, name, email address, and phone number.
- Your Colorado license or certificate type.
- Your practice name and location, including address, city, county, state, and ZIP code.
- The name of the certifying institution or regional Area Health Education Center (AHEC) office.
Provide the certifying institution or AHEC office with:
- The name of each student you instructed.
- The Colorado institution of higher education where each student is enrolled.
- The degree or certification each student is seeking.
- The dates of the preceptorship.
- Any other information the certifying institution or AHEC office requires.
The completed form needs your signature and date, plus certification signed and dated by the institution or AHEC office.
How to file
- Complete your identifying information, license type, practice location, and certifying institution or AHEC office information on DR 0366.
- Review the declaration, then sign and date the form.
- Send the form and required student information to the institution for which you teach or the regional AHEC office with jurisdiction over your practice location. The institution may be a college or university, hospital, clinic, or other medical facility.
- The institution or AHEC office reviews your eligibility, enters the number of eligible students, and completes the certification with a signature, date, printed name, and title. It returns the signed original to you.
- Promptly email the completed, certified form as an attachment to DOR_Preceptor@state.co.us.
The Department will notify you whether your credit is issued or denied.
Common mistakes
- Delaying submission after certification. The form reminds preceptors to submit the completed form promptly. Only 300 preceptors per year may claim the credit, and credits are issued in chronological order based on the timestamp of the Department's receipt of the preceptor's email with the completed certification attached.
Questions people ask
How much is the credit?
The credit is $1,000, regardless of how many preceptorships you undertake during the tax year.
Do the four working weeks or twenty business days have to be consecutive?
No. The qualifying weeks or business days do not have to be consecutive, but they must occur during the tax year.
Can a paid mentoring experience qualify?
The form defines a preceptorship as an uncompensated mentoring experience involving personalized instruction, training, and supervision of eligible health professional students.
Who can certify my eligibility?
The institution for which you teach or the regional AHEC office with jurisdiction over your practice location can certify your eligibility. The institution may be an institution of higher education, hospital, clinic, or other medical facility.
Can the AHEC office charge for certification?
Yes. The AHEC program may charge a reasonable fee for providing certification.