« Job Shadowing MD

Job Shadowing - Provider (Wisconsin)

Thank you for your interest in job shadowing at HSHS in Wisconsin. Please complete the steps below to begin the application process.

Man in lab coat smiles while female in lab coat works on a computer in the background

Please Note: If you are an HSHS or Prevea colleague, please complete the HSHS Job Shadow Agreement Form located in the HSHS Job Shadow Policy and submit to [email protected].

Review the HSHS Job Shadow Policy and complete pages 3 & 4 at the end of the policy. Complete and submit the form with this application. (see “Upload HSHS Job Shadow Policy Form” below)
Submit Completed Job Shadow Form along with all required Health Requirements. All requirements are listed on page 3 of the agreement to [email protected].
Once all information is processed, a representative will contact you.

Any questions regarding job shadowing, please contact [email protected].

Prevea Health Job Shadowing Opportunities

HSHS Wisconsin hospitals work closely with Prevea Health in locating and placement with a sponsor. Additional information about job shadowing with Prevea Health can be found here.

Name

U.S. phone number

Address

City

State

Zip Code

School/Organization

Sponsor

Required for Hospital and HSHS Medical Group Shadows

Sponsor Phone Number

Sponsor Email

Requested Ministry

HSHS St. Vincent Hospital | Green Bay, WI HSHS St. Mary's Hospital | Green Bay, WI HSHS St. Nicholas Hospital | Sheboygen, WI HSHS St. Clare Memorial Hospital | Oconto Falls, WI

Location or city to be observed

Department or unit to be observed

Reason for observation

Date you wish to shadow

Are you currently doing a clinical at an HSHS facility?

Yes No

If Yes, indicate location

I have read the HSHS Job Shadow Policy

Yes No

Upload HSHS Job Shadow Policy Form

Please select a file

Upload HSHS Job Shadow Immunization Attestation

Please select a file

Upload Immunizations

Please select a file

Upload TB Skin Test, Chest X-ray Report done within 1 year or TB Screening Checklist

Please select a file