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Job Shadowing

Job Shadowing Application

* Required

First Name:
*

Last Name:
*

Phone Number:
( ) - - *

Parent/Guardian contact number (if applicable):
( ) - -

E-mail Address:
*

Verify E-mail Address:
*

Are you 18 or older?:
*

Are you a nursing student?:
*

If you answered Yes to the above question:
Graduation Date:

Name of School:


Which healthcare career are you considering?:
*

School Name:
*

School Status/Year:
*

School Contact Reference:
*

List specific dates that you are available to shadow Mon-Fri between the hours of 8:00 a.m. and Noon.
(Shadowing times may vary by division.)
Please allow 2 weeks for us to coordinate your shadowing opportunity.
*

Division you would like to shadow:
Nursing
6500 (Med/Surg ICU)
6600 (Telemetry)
6700 (Cardiovascular/Pulmonary Stepdown)
7600 (Med/Surg/Renal)
7700 (Oncology)
8600 (Orthopedics)
8700 (Surgical)
9600 (Neuroscience)
9700 (Med/Surg/Pulmonary)
CVICU (Surgical/Cardiovascular ICU)
Labor and Delivery
Operating Room (College Sophomore minimum requirement)
Nurse Anesthetists (Nursing Students Only)
Surgery Tech
Mother/Baby
Emergency Room
Special Care Nursery

Therapy Services
Physical IP
Physical OP
Speech
Respiratory
Occupational IP
Occupational OP
Cardiac Rehab

Other
Radiology (X-Ray)
Radiology (Ultrasound)
Radiology (Nuclear Medicine)
Radiology (MRI)
Radiology (CT)
Sleep Medicine
Vascular Lab
Hyperbaric Medicine
Cardiology Services
Pharmacy (College Freshman minimum requirement)
Laboratory