24/25 SE NE AHEC High School Job Shadow Request

Confidentiality & HIPAA I understand I will be required to complete and pass the AHEC Confidentiality & HIPAA training prior to attending my job shadow. I understand the link for the confidentiality & HIPAA training will be emailed to me and I am expected to complete the training in a timely manner (type initials below):

Dress Code Dress in a manner that presents professionalism. • Participants must dress modestly and neatly with shirts tucked into pants. • Wear khakis or dress pants – NO DENIM or JEANS please. • Do not wear pants with holes, rips, or tears. Including those made with rips, tears, or holes as part of the design. • Please avoid extreme dress, hairstyles and jewelry. • Do not wear clothing that portrays suggestive or derogatory pictures and messages, advertising of alcohol, tobacco, etc. • Clothing should cover all undergarments and midriffs. • No sleeveless blouses, shirts or tops. • Clothing should not be skin tight or revealing. • The wearing of nose, eyebrow, tongue, lip and body jewelry is prohibited during shadowing hours. • Body tattoos must be covered during shadowing hours. • Wear flat comfortable shoes – NO SANDALS, FLIP FLOPS OR OPEN-TOED SHOES. You are encouraged to wear clean tennis shoes and socks. • You may be asked to change into scrubs or a lab coat. There may be other site specific restrictions. I have read and agree to abide by the above dress code policy. I understand dress code will be strictly enforced (type initials below):

Cell Phones Cell phones are not allowed during shadowing. Students using a cell phone during a shadowing experience will be asked to leave immediately and may be restricted from future shadowing. To maintain confidentiality absolutely NO PHOTOS, TEXTS, or POSTINGS may be done related to job shadowing experience. I have read and agree to abide by the above cell phone policy (type initials below):

Additional Rules • Some sites may require you to provide official documentation of current immunizations, flu, and COVID vaccinations. • Some sites may have additional forms specific to their site for you and/or your parent or legal guardian to complete. • You are expected to appear and behave in a professional manner throughout your job shadow experience, as healthcare is a professional environment. • Arrive on time and be polite, courteous, and enthusiastic. If the site is unfamiliar to you, do a trial run to the site. If you are going to be late or are unable to shadow on shadowing date, please call in to the site.**No call/no show limits future shadowing. • Always remember to ask questions. Shadowing sites are taking time from their busy day to share with the student their profession. Not asking questions can be viewed as the student is not interested in their field. We understand that many times the health professional has answered all your questions and you are overwhelmed, but it is important that you ask a couple of questions. For example, "What do you enjoy most about your profession?" or "If you could have chosen another health profession what would it be?" • Personal valuables, including cell phones, should be left outside of the facility.
I have read and agree to abide by the above additional SE NE AHEC job shadowing rules (type initials below):

I have read and agree to abide by all of the above Southeast Nebraska AHEC policies and rules for job shadowing and any additional site specific policies for shadowing. Student Signature (type full name below):

Parent Signature (if under 19 years of age):