Get Usa Health Observation Student Application_dsa

The USA Health Observation Student Application_DSA provides aspiring healthcare students with the opportunity to observe professionals in a clinical environment. Filling out this form accurately is essential to facilitate your observation placement.

Follow the steps to complete your application effectively.

1. Click ‘Get Form’ button to access the application and open it for editing.
2. Begin with the personal information section. Fill in the date, your full name, date of birth (D.O.B), student identification number (J# for USA students), address, city, state, phone number, zip code, and email address.
3. Provide emergency contact details, including the name, phone number, and relationship of your emergency contact person.
4. Indicate whether you have a family member working for USA Health. If yes, please provide their name, facility, and department.
5. Select your preference for observation, either Clinical Observation or Interview. Specify the facility of your interest — University Hospital, Children’s & Women’s Hospital, Physician’s Group, Mitchell Cancer, or Healthcare Authority.
6. List the specific department(s) you are interested in observing. Note that certain departments are not available for observation.
7. If you are shadowing a provider/department, complete the corresponding section by filling out the Provider/Department name and specialty/department details. Confirm whether you have received approval from the provider/office before proceeding.
8. If you are applying for an interview, provide the details of the department, position, or person you wish to interview.
9. Complete the orientation section, acknowledging you understand the requirement to participate in an orientation covering essential hospital competencies.
10. In the required immunizations section, ensure you have documentation for all necessary vaccinations. Attach proof of these immunizations when submitting your application.
11. Attach a letter from an academic advisor, outlining your desire for the shadowing experience.
12. Fill out the release from liability section, ensuring it is signed by participants and any guardians, if applicable.
13. Complete the acknowledgments & confidentiality pledge, confirming your understanding of confidentiality responsibilities.
14. Finally, compile and send the completed application with all required documentation to the provided email address. Once your application is processed, you will be contacted regarding placement.

Complete your application online today for the opportunity to observe healthcare professionals!