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BVRMC Career Exploration
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1.
Name (first and last)
(Required.)
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2.
Email Address
(Required.)
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3.
Phone number
(Required.)
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4.
Which school do you currently attend?
(Required.)
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5.
What grade are you in high school?
(Required.)
Junior
Senior
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6.
Which hospital department(s) are you interested in job shadowing? (
Select all that apply)
(Required.)
Nursing- Medical/Surgical
Nursing- Emergency Room
Nursing- Operating Room
Nursing- Same Day Surgery/Endoscopy
Nursing- Obstetrics
Physical/Occupational Therapy
Radiology
Laboratory
Pharmacy
Fitness & Health Center
Respiratory Therapy
Office Professional
Interpreter Services
Other (please specify)
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7.
Have you already arranged this Career Exploration experience with a staff member?
(Required.)
Yes
No