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Department (Non-Doctor) Shadowing Form

Thank you for completing our job shadowing learning session! Please complete the form below with your information.


As a reminder, submission of the below inquiry form is to request time to shadow an employee or department within Bryan Medical Center. If you would like to shadow a doctor, physician assistant, nurse practitioner or other provider, click here.


* Denotes required fields
* Are you under 18 years old?

Required Immunizations

To shadow at Bryan Medical Center, history of immunity/immunizations for the following diseases is required:

  • Mumps, Rubella, Rubeola (MMR)
  • Varicella or past history of chickenpox
  • Hepatitis B
  • Flu shot (required September 1-March 31); must be received at least two weeks in advance of shadowing within the required period
  • Negative tuberculin (TB) skin test or follow-up care for previously positive TB skin test (required to be be completed within the last two years)
  • DPT/TDAP (Diphtheria, Pertussis, Tetanus)
*  

Confidentiality Agreement

Review the confidentiality agreement.

*  

Required Forms

Print and bring the shadowing record sheet on the day(s) of your shadowing experience.

Human Resources Office Location: Bryan East Campus, 1600 S. 48th St.
Hours: 7:30 a.m.- 4:30 p.m., Monday-Friday
Phone: 402-481-8610

Reminder: Submission of this inquiry form is to request time to shadow an employee or department within Bryan Medical Center. If you would like to shadow a doctor, physician assistant, nurse practitioner or other provider, click here.

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