Shadowing Interest Form

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Please fill out this form if you are interested in shadowing a pediatric pharmacist over winter break or spring break! Please indicate where you would like to shadow as well as what your top 3 shadowing preferences are!

Deadline: Friday, November 3rd

P.S. If neither of these times work for you this year, it is okay! We will be organizing summer shadowing experiences in the spring as well!!

First Name

Last Name

When are you interested in shadowing?

Winter Break 2023

Spring Break 2024

Clear selection

Where are you interested in shadowing?

Reminder: There may a cost associated with AFCH, but you will likely be able to shadow more than once.

American Family Children's Hospital (Madison)

Children's Wisconsin (Milwaukee)

Clear selection

If you picked Children's Wisconsin, please select your top 2-3 shadowing preferences:

General Pediatrics

Neonatal Intensive Care

Pediatric Intensive Care

Hematology/oncology

Chemo Clinic

Emergency Department

Overnights

N/A

Submit

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