Student Observers Request Form

Thank you for your interest in shadowing at The Jackson Clinics. Please complete the information request form below and upload all required paperwork.


Please allow for at least 2 weeks from your preferred start date in order for us to process your request.


Note: you will be unable to shadow without completing all required paperwork.


Questions? Email mgretka@thejacksonclinics.com

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Please upload the following documents as a PDF:

  • Driver's License (Front)
  • Proof of Health Insurance
  • Completed and signed TJC Observation Agreement
Drag and drop files here or