Pre-Health Professions Club Shadowing Form

As part of the Pre-Health Professions Club, you can complete a minimum of 15 hours shadowing a healthcare professional. This form is to help us know what you are interested in so that we can place you in a setting most advantageous to your desired healthcare goals.

All fields marked with asterisk (*) are required.

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Name (First, Middle Initial, Last)*

(First, Middle Initial, Last)

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Healthcare Profession of Interest*

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Setting of Interest*

(i.e. outpatient clinic, dental office, veterinary hospital, physician office, pharmacy, etc)

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What is your shadowing availability? (time must be in at least 2-hour blocks)*

Include day of week and times (e.g. Monday, Friday: 1:30-5:30pm, Thursday 8:30-10:30am)

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Prior Shadowing Experiences

Please include the location/facility and number of hours completed at each.

Link (required)