Thank you for your interest in a shadowing a provider at HCC Network.  

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Students must be at least 16 years old, parental permission granted, and should be part of a

pre-health profession class, program, HOSA chapter, etc.  

 

Once approved, the following items will be required along with submitting a photo ID. 

 

• Student registration form

• Legal Guardian Consent Form

• Confidentiality Form

• Emergency Contact Form

• Handbook Acknowledgement and Receipt Form

• Policies and Procedures Agreement Form

• Gratuitous Services Form

• TB Form

• Flu Form

• HIPAA training Form

 

Please print, complete, scan and email forms to Stephanie.taylor@hccnetwork.org.

Please forward any questions or comments to Stephanie at the email above or call 816-617-2353.