I am available on these dates and times:
School Information (if applicable)
When I click "submit" below, this form will be delivered electronically to the requested site's Student Placement Representative. This form must be received at least two weeks before requested observation date. If your request is approved, an observer orientation will be coordinated. Proof of either a current negative TB skin test or a negative chest X-ray performed and flu shot in the last 12 months are also required for all approved observation experiences. Proof of these requirements must be shared with the Student Placement Representative.
By checking here, 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. Observation experiences will not be granted in the following areas: CVICU, ED, ORs, NICU, and Forensic Nursing.