NOTE: Existing Students who have filled out this application before, please click here to login to the Allegheny Health Network Volunteer Portal to fill out your form.Before beginning this application you must have the following information and documents ready to upload:
- TB Test Results: Tuberculin status (PPD) documented within the last 12 months. (If positive results - must provide copy of radiology report and doctor's letter).
- Email confirmation from person you are shadowing/observing: Confirmation must include date and time of the experience that matches the application request
- Name of person that applicant will shadow: Include mentor's email and phone number
- Date/s of experience: Date/s must be specific. Date ranges, TBD, ANY responses are not permitted
- Start and end time of experience: Time that you will be on site. Example 9am-12pm
- Number of total hours you will observe: Maximum 16 hours per calander year
- Where applicant is to report for shadowing experience: Hospital/Site location and department name
Applications must be submitted 10 business days prior to the experience date.