Physician Host Invitation: SSVMS White Coat Week 2022

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We need volunteers! Thank you for your interest in serving as a physician/medical professional host for our White Coat Week.

As part of our Future of Medicine program, SSVMS is offering students a chance to shadow a physician to learn more about careers in medicine during their spring break.

Job-shadowing dates will be Mon-Thurs, 4 hours per day during spring break from:
3/14/2022 - 3/17/2022
4/11/2022 - 4/14/2022.

Physicians are welcome to host during one or both of the spring break weeks! Physicians at the same location can split time hosting students.

Students will be rising juniors and seniors, and will have up-to-date vaccines, including full COVID vaccination. Their role will be purely observational, and students will adhere to strict rules of confidentiality.

Please contact Marlee Turner at mturner@ssvms.org with any questions.

Name *

Email *

Phone Number *

Title/ Specialty *

Medical Group or Affiliation *

Office or Practice Address *

Job-shadowing Address (if different from above)

Contact Name (Office Manager, etc) *

Dates Available and Willing to Host (Can select more than one) *

Mon, March 14 - Thur, March 17

Mon, April 11 - Thur, April14

I am available in June and/or July to host students

Required

Number of students you can host per day? *

1 student

2 students

3 students

4 students

5 students

Other:

Do you know other medical professionals who would like to host a student? (please share contact information)

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms