Please complete this required form to be considered for a pediatric specialty clinical placement at Connecticut Children’s. After submission, we will inform you by email within 2 weeks whether there is preceptor available to accommodate your request.

• Student Placement For Nurse Practitioner, Physician Assistant, and Certified Registered Nurse Anesthetist students currently enrolled in an accredited program.

• Pre-Nurse Practitioner and pre-Physician Assistant Students – Clinical shadow experience for undergraduate college students (must be 18 years of age) to observe the work and learn about the career of a nurse practitioner (NP) or physician assistant (PA). Clinical shadow is a one-time observation only experience, (up to 4 hours) under the supervision of a NP or PA sponsor