• Request for Observation
• Advance Your Education
• Pre-Health Professions
• Student and On-Site Instructor Health & Safety Requirements
• RN Refresher
• Request for Internship

Request for Observation

Observation experiences at Scottsdale Healthcare are a great way to learn about a specific department or job at Scottsdale Healthcare. To maximize the experiences of patients and observers, observational periods are usually four hours in duration. Observation experiences are "hands-off" opportunities, regardless of an individual's training or education and are usually limited to no more than one shift of observation.

**Please note, if you are seeking a possible experience with a physician, PA, or post-baccalaureate nurse (such as a nurse practitioner), please contact Scottsdale Healthcare's Graduate Medical Education department at 480-323-3776.

To be considered for a potential experience, please complete the application below.  Fields in bold are required.  When identifying three possible observation dates, please select dates that are at least two weeks after the date that this form is submitted.

Your Information

First name

Last name

Phone

Email

Observation Information

Requested Scottsdale Healthcare campus

OsbornSheaThompson Peak

Requested Scottsdale Healthcare department

Requested completion date

I am requesting an observation experience:

to meet a school requirementfor personal interest

I am available on these dates and times:

Date:

Time:

Date:

Time:

Date:

Time:

If you are looking to meet a school requirement, will you be submitting a paper or completing a project highlighting your observation experience?

YesNo

Agree

By submitting a paper or a project to my school or university, I acknowledge that Leah Hill, Student Programs Coordinator, must receive an electronic copy of my paper or a script of my presentation to ensure that no information regarding patient care is presented. This is a Scottsdale Healthcare requirement.

Paper/Project Due Date

Date draft will be submitted to Leah Hill

(**Draft must be submitted at least 1-2 business days before the paper or project is due at the school)

School Information (if applicable)

Does this experience meet a school requirement?

YesNo

What school/college/university assigned this project?

Who assigned this project (instructor's name)

Instructor's contact information (phone number or email address)

If your request for an observation is approved, what do you hope to gain from this experience?

Please provide your resume or curriculum vitae by copying and pasting it below.

Please return this form to Leah Hill, Student Programs Coordinator, upon completion. This form must be received at least two weeks before requested observation date. If your request is approved, an observer orientation will be scheduled. Proof of either a negative TB skin test or a negative chest X-ray performed in the last 12 months is also required for all approved observation experiences. Proof of either of these tests may be brought to the scheduled observer orientation.

By signing below, I acknowledge that the above information is accurate. I also authorize that this completed form and any additional relevant information may be shared with Scottsdale Healthcare staff members for the sole purpose of networking and possibly fulfilling my request for observation. I also authorize that if I am requesting an area such as the NICU, ICU, Emergency Department, Operating Rooms, or SANE that I am eighteen years or older (due to safety, infection control, and confidentiality issues).

Signature

Agree

Submit