Get University Of Utah Application

Completing the University Of Utah Application is an important step for individuals interested in shadowing health care providers at the University of Utah Health Sciences Center. This guide provides clear and supportive instructions to ensure a smooth online application process.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application form and open it for editing.
2. Begin by entering your name in the appropriate field labeled 'Name of Person Applying to Shadow'. Follow this by filling out your employer or affiliation in the designated section.
3. Input the name and PeopleSoft number of the person you will be shadowing in the respective fields.
4. Provide your contact information, including home phone, work phone, and email address. Ensure that these details are accurate for communication purposes.
5. Indicate your age in the field provided, confirming that you are 18 years or older.
6. Specify the purpose of your shadowing experience by selecting the relevant option and providing additional information as needed.
7. Enter the dates you plan to shadow in the designated area.
8. Detail the number of hours you expect to spend shadowing. If this exceeds eight hours, note that HIPAA training must be completed.
9. List the UUHSC locations you will visit during your shadowing experience.
10. Indicate the types of health care visits or procedures you will observe.
11. Answer whether you will be present during any health care visits or treatments of patients. If yes, provide the names or categories of patients and their locations.
12. Read and affirm the representations outlined in the form to confirm your understanding of the responsibilities involved.
13. Sign the form in the 'Shadower’s signature' area. If you are under 18, ensure a parent or guardian also signs.
14. Obtain the required signatures from the workforce member being shadowed, the Service Director/Clinical Admin Manager, and the Medical Director/Chair.
15. Once all sections of the application are completed accurately, save any changes you have made. You may also choose to download, print, or share the completed application.

Begin your application online today to experience valuable shadowing opportunities.