Observation/Job Shadow Request Form

Story County Medical Center is delighted that you have chosen us to be a part of your healthcare education experience.  To ensure that our patients are protected and students are well prepared, we require all students to complete organizational requirements prior to beginning their student experience at Story Medical.  In addition, students must be at least 16 years old by the date of their observation / job shadow.  You will find the steps you need to continue your student journey below: 

  1. Complete the Observation / Job Shadow Request Form below at least two weeks prior to the requested observation date. Your request will be forwarded to the department(s) you identified as an interest and an HR representative will contact you with additional information.  Please Note: Observation / Job Shadow requests are accepted on department availability to accommodate the request. 
  2. Once the Observation / Job Shadow has been approved and scheduled, you will be provided with the Observation / Shadowing Orientation module for review.
  3. After completing the orientation module, print and sign the Observation / Job Shadowing Attestation Form.  If under age 18, a parent or guardian will also sign the form in the designated area.  
  4. On the day of your Observation / Job Shadow, bring the signed attestation form with you, and hand in at the main entrance information desk.  You will be issued an observer ID badge at this time and a member of your assigned department will greet you.  Badges will not be issued and observation will not take place without completed documents prior to the student experience.   

To ensure that our patients are protected and students are well prepared, we require all students to complete organizational requirements prior to beginning their student experience at Story Medical.

Application