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Cone Health Student Observation/Shadowing Program

If you are a student interested in pursuing a clinical observation/shadowing experience on any of the Cone Health hospital campuses, please submit the documents listed below. 

Before you submit the documents, please review Sections 17 and 18 of the Medical Staff Bylaws, Rules and Regulations, as well as the Student Observation Orientation Presentation.   NOTE:   Shadow experiences are limited to no more than 20 hours per year, unless a longer period is specifically approved by the Chief of Service.  

Required Documents

Goals and Objectives
 - please complete all spaces. 

Letter Physician / Staff Approval

All spaces must be complete including the location and date(s) of the shadow experience and the signature of the supervisor (if the person is staff rather than a physician).  NOTE:  Shadowers are responsible for identifying their own mentors.  No placement services are provided.

COLOR Copy of Photo IDMust be a clear, legible, color copy.

Seasonal Flu Vaccine

Documentation showing that you have received the current, seasonal flu vaccine is required for all shadow experiences that fall between the dates of October 1 and March 31.  No exceptions.

TB Test Results (current)TB test must have been read within 1 year of the shadow date. 

Parental/Guardian Consent
 - If student is under 18 years of age.

HIPAA form
 - all areas to be completed.

Acknowledgement Form
  - complete all spaces.

Corporate Compliance Test
 - complete all questions.

Safety at Work Test
 - complete all questions.

Documents may be emailed to: or faxed to:  336-832-3909 (please note this is not a color fax). 

For More Information

Please contact Marsha Honeycutt, Senior Executive Assistant:  336-832-3900.

Also in this Section

Health Care Professionals

  • Student Observation / Shadowing