Thank you for your interest in volunteering with the Student Shadowing Program (Shadowing Program).

The Shadowing Program is a collaborative offering from the Alberta Medical Association's Section of Family Medicine, Section of Rural Medicine, and the Alberta College of Family Physicians. The program provides new medical students from the Universities of Alberta and Calgary with the opportunity to experience the specialty of family medicine and all it has to offer!

Your responses to the following questions will aid us in the matching process.

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* 1. Please note that your answers will be shared with your shadowing student.

Contact information

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* 2. First name

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* 3. Last name

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* 4. Pronouns

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* 5. Best email address for your shadowing student to reach you at

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* 6. Best phone number for your shadowing student to reach you at

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* 7. Is this phone number a...

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* 8. What is your preferred method of communication from your shadowing student when preparing for the shadowing placement?

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* 9. What is your preferred method of communication from your shadowing student for any follow-up or debrief after their shadowing placement?

Shadowing placement information

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* 10. Please provide the following information about where the shadowing placement will take place. If you work in more than one location and the placement location will depend on timing, please indicate that in the "Additional information" question below.

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* 11. Is there any additional information that we should know about the location of your shadowing placement? (e.g. details about accessing the location, if you work at more than one location, paid parking information, etc.)

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* 12. Which of the following best describes the location(s) where you will be hosting a shadowing student? Please select all that apply.

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* 13. Please provide a brief description of your practice and typical schedule (e.g. “I usually work Mondays at the long-term care facility, on Tuesdays I teach a class, Wednesdays-Fridays I am at my private general practice clinic”, or “I work M-F at our family medicine clinic that provides pre-natal care and am also on call for deliveries at the local hospital.”)

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* 14. I am open to:

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* 15. Based on your likely schedule and any planned time off, which days do you anticipate being able to host a shadowing student? Exact hours and times can be finalized with your student upon matching and you will not be expected to host a student every day you select; this is just an approximate overview of your availability.

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* 16. Will your shadowing students need to complete any additional paperwork or other requirements for your workplace’s policies in order to be able to complete their shadowing placement? (e.g. AHS External Participant Job Shadow registration, etc.) If so, please briefly describe the requirements.

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* 17. Are there any additional personnel in your workplace that should be contacted to assist with scheduling and other preparation for shadowing? If so, please provide their name and contact information here.

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* 18. Do you have any questions for us about the shadowing program or placement process?

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