Health Requirements: shall not be permitted to job shadow until the participant provides a complete health history of communicable diseases and immunizations to the Human Resources department, including but not limited to:
• A physical examination in the past 12 months
The above health requirements, must be received prior to the Job Shadow. It can be presented in the form of copies of the items listed or in a signed letter from a physician’s office or school verifying the existence of these health requirements. Any costs associated with obtaining the required health records or requirements will be the sole responsibility of the individual requesting the job shadow.
As the requester of the job shadow, I understand that Wheaton Franciscan Healthcare (WFH) will make all attempts to arrange the job shadow as requested. I must meet the health requirements set forth above as well as meet with a Representative of WFH to complete a job shadow orientation packet prior to the experience.
Agree
Do Not Agree
All
Participant's Name:
Address (street,city,state,zip):
School/Organization:
Grade/Level:
Are you at least 16 years of age?:
Yes
No
Daytime Telephone Number:
E-mail Address:
Requested Occupation to Shadow:
Requested Department where Job Shadow will Occur:
Reason for Requesting Job Shadow:
