Shadowing Interest Form

Shadowing Interest Form

If you are interested in Shadowing at St. Bernards, please answer the following questions. If you are a current St. Bernards employee, please contact the Talent Acquisition office at 870-207-4916 instead of completing the form below.
Requirements to shadow: You must meet the grade requirements below. If shadowing during winter months (October-March), you must present proof of current flu vaccination to shadow.

The amount of time allowed for shadowing:
- Jr. High and High School students – 2 hours
- College students – 4 hours
Age Requirements for Shadowing:
- Non-patient Care areas – 8th grade and above
- Most Patient Care areas – 10th grade and above
- Emergency Department – 12th grade and above
IMPORTANT: We limit shadowing opportunities to one per month.
STEP ONE: STUDENT PAPERWORK SUBMISSION

You will need to first download the required paperwork to complete and upload to this form by going to https://bit.ly/stbstudentpaperwork. You can not submit a request without first completing this paperwork.

Once you complete the paperwork, come back to this form, and upload the completed documents below.

IMPORTANT: Please note that if the forms are not signed by your school, parent/guardian (if under 18) and completely filled out and uploaded below, your submission will NOT be processed.
Upload the Required Student Paperwork (provided in the link above) that must be completed and signed here. Must upload all of the required paperwork into one PDF or Word Document and attach below.

Browse Files
Must be in PDF or Word Document form Cancelof
STEP TWO: Shadow Request Student Details
Name

First NameLast Name
School:
Please list your school if you're a student
Age:
Current Grade in School
Email
example@example.com
Phone Number:

Area CodePhone Number
What is the purpose for this request?
Please Select the Department(s) you wish to shadow (See above age requirements for the departments you can shadow):

Other
Please submit proof of your Flu Vaccination (only needed if shadowing during the winter months from October-March):

Browse Files
Can be a JPEG, PDF, GIF, PNG format. Cancelof
Once you submit this information, our team will be reaching out within 2-3 business days with further details. If you have any further questions, you can reach out to studentshadowing@sbrmc.org. Thank you for your interest in shadowing at St. Bernards.
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