Student Observership Application

Students may fill out the online form below, or download the application and mail/email the completed form.

If you are completing the form online, you must submit the Health Requirements Checklist via mail or email.

Completed applications and the Health Request Checklist form can be sent via mail/email to:

Shannon Hilliard
Director of Nursing
Mount Nittany Physician Group
1600 University Drive
State College, PA 16801

Application completion reminders:

  • The application form must be fully completed before submission. Incomplete applications may significantly delay the review process.
  • Be sure to include the required paperwork with appropriate signatures.
  • Please submit the Health Requirements Checklist. Do not send copies of personal health records.
  • PA State Police Clearance must be received prior to starting your hours, and must be current (within 12 months). It may take several weeks for your request to be processed.

The review process may take at least four weeks to complete after the application is received.

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