Host a Student

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Thank you for your interest in precepting student shadows!

Please indicate your availability below to help us match students.
The shadowing program will run from Monday, June 17, 2019, to Thursday, June 27, 2019, on Mondays - Thursdays.

* Indicates required field

Name *

First

Last

Email *

Organization/Health System *

I'm available for... *

Monday 9am-1pm (6/17/19) Monday 1pm-5pm (6/17/19) Tuesday 9am-1pm (6/18/19) Tuesday 1pm-5pm (6/18/19) Wednesday 9am-1pm (6/19/19) Wednesday 1pm-5pm (6/19/19) Thursday 9am-1pm (6/20/19) Thursday 1pm-5pm (6/20/19)

I'm available for.. *

Monday 9am-1pm (6/24/19) Monday 1pm-5pm (6/24/19) Tuesday 9am-1pm (6/25/19) Tuesday 1pm-5pm (6/25/19) Wednesday 9am-1pm (6/26/19) Wednesday 1pm-5pm (6/26/19) Thursday 9am-1pm (6/27/19) Thursday 1pm-5pm (6/27/19)

How many students can you host? *

If your availability is different than the options listed above, please indicate that in the "Additional Comments" below.

Additional Comments *

If your availability is different than listed above, please indicate below.

Thank you for your commitment to diversifying the future of healthcare and a Helix team member will be in contact with you shortly!

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Home
About
Program
Gallery
Support Us
Host a Student

Thank you for your interest in precepting student shadows!

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Services

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Contact