College-Required Experience
If your college or university requires observation hours, hands-on clinical rotations, or internship experience, Great River Health is happy to help. To apply, submit this form at least 30 days prior to your requested observation date and at least 60 days prior to your requested rotation or internship date(s). Please note that placement is not guaranteed. Email students@greatriverhealth.org with any questions.
Name
*
First Name
Last Name
Number
*
Email
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of school
*
Program or course of study
*
What type of experience are you applying for?
*
Observation
Clinical rotation
Internship
Other (please specify)
Is this experience required for your academic program?
*
Yes
No
Department or clinic requested
*
Number of hours requested
*
Preferred date(s) of experience
*
Preferred location
*
Fort Madison
Mount Pleasant
West Burlington
No preference
Name of program director or adviser at your school
*
First Name
Last Name
Director/adviser's number
*
Director/adviser's email
*
Are you a current Great River Health employee?
*
Yes
No
What is your job title?
*
Do you have relatives who have worked or currently work at Great River Health?
*
Yes
No
What is their name?
*
How did you hear about this program?
Submit
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