Health Career Exploration Application

This information will be kept confidential and used only in conjunction with this program.

Please note: Participants will be assigned to one of five clinical observation groups based on interest area/availability. If you do not rank the options in its corresponding box when filling out the form below, you will be assigned based on availability.

The five clinical observation options are:

  • Behavioral Health Patient
  • Pediatric Asthma Patient
  • Obstetrical Patient
  • Surgical Patient
  • Critical Care Patient

Reminder: Please complete the Confidentiality Statement and Authorization Form (if under 18 years of age).