24/25 SE NE AHEC College Job Shadow Request 

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Southeast Nebraska AHEC Job Shadow Request Form.

Please complete the information below to request assistance with job shadowing placement.

This information is voluntarily collected as part of a federal grant. Your information is kept confidential and de-identified. This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U77HP21499. All information on this form is collected for required data reporting requirements and is deidentified for all reporting purposes. If you have questions, please reach out to Vanessa Meinberg at vmeinberg@southeast.edu

Demographic Data








List the zip code of your hometown.







College Information



Job Shadow Areas of Interest







Southeast NE AHEC Shadowing Policies
Confidentiality & HIPAA

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, illegal drugs, 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 specific restrictions. 

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.

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 take 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 may be 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 not be brought in to the facility.



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