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NEBP OJS Program Interest Form

Are you interested in participating in CAMRT's National Experiential Bridging Program (NEBP) Observational Job Shadowing (OJS) Program as a clinical site? Please complete this short survey and we'll get in touch with next steps!

The questions marked with an asterisk* are required.

Privacy Notice: The contact information collected through this form will be used solely for the purpose of communicating with you about the NEBP OJS Program. Your information will be accessed only by authorized CAMRT staff and will not be used for unrelated communications.
1.What is the name of your organization?(Required.)
2.Who is the primary contact person for the OJS Program at your organization?(Required.)
3.What province or territory is your site located in? Please select one of the following.(Required.)
4.Is your organization public or private? Please select one of the following.(Required.)
5.Which MRT disciplines are available for observational experiences at your site? Please select all that apply.(Required.)
6.Does your site have MRT staff interested in serving as mentors/preceptors for IEMRT observers? Please select one of the following.(Required.)
7.Does your organization have a clinical educator or designated contact person for learner coordination? Please select one of the following.(Required.)
8.Would your site be able to host IEMRTs for observational experiences of approximately 15 - 25 hours? Please select one of the following.(Required.)
9.Approximately how many IEMRT observers could your site accommodate at one time?(Required.)
10.Would IEMRT observers have opportunities at your site to observe interprofessional collaboration and Canadian healthcare workflows? Please select one of the following.(Required.)
11.Does your organization require any of the following prior to observation? Please select all that apply.(Required.)
12.Is there any additional information you would like CAMRT to know regarding your organization's interest in participating as an OJS partner site?
Thank you for your interest!
Current Progress,
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