Required Forms to Complete

Please print, complete in full, and send the following application to the below identified email based on student type: 

      Application for Observation 

• MD, DO, NP, PA students: inlandstudentprogram@northernlight.org​
• Nursing, Radiology, Occupational Therapy, Physical Therapy, Pharmacy Students/Techs, Audiology, Medical Assistants, Medical Laboratory Scientists/Technicians: mskehan@northernlight.org

The Inland Hospital student coordinators will identify potential preceptors in the specialty requested and will inform you if your application has been accepted.

If your application has been accepted, please complete these forms below.

1. Review, print, sign the following documents:

   • Confidentiality Statement
   • Observer Code of Conduct   
   • Dress Code for Future Health Care Observers  
   • Notice of Privacy Practices
   • Employee Health Students/Instructors Immunization Requirements

Your application will be put on hold if any of the required forms are missing.