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Department of Neurological Surgery - Observership Program

Please submit this application if you are interested in observing in the Department of Neurological Surgery at UT Southwestern Medical Center.

Want to expedite your application?
Please email your immunization records to brianna.morales@utsouthwestern.edu upon completion of this form.
1.First and Last Name(Required.)
2.Email Address(Required.)
3.Who has agreed to host you? (NOTE: You are responsible for finding a host to shadow)(Required.)
4.Please upload a letter or email from your host stating their approval for you to shadow them. (If you are under 18, ENSURE your host is aware of your age and still approves your participation.)(Required.)
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5.What are the planned or agreed-upon dates between you and your host? (Start date MUST be at least 6 weeks from the submission of the application.)(Required.)
Start Date
End Date
6.Please attach your current resume/CV(Required.)
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7.Select the one that best fits you.(Required.)