Career Exploration

Career Exploration

If you're an FCB student, please fill out the LINKED form, not this one.

This form is for University of Colorado MD program students that are pursuing a career exploration opportunity.

Before you submit this form, please be sure you have the following:

An email confirmation from the faculty member with whom you will be working that they approve of this experience and indicating that they have read and understand the Career Exploration Clinical Experiences policy that can be found in the school's Policies and Procedures.

Please follow the instructions below to obtain this approval:

Copy and paste the text from this message into an email to your faculty member. Upload the email approval with your faculty member's response.

Student First Name*

Student Last Name*

University Email*

Student Phone Number*

Medical School Year*

*MS2 students in their LIC year should arrange Career Exploration experiences with their LIC director and LIC coordinator and should not fill out this form

Select or enter value

Are you currently on LOA or academic warning?*

*If you are on LOA or academic warning, you may not participate in career exploration without explicit approval from a Dean in the Office of Student Life.

Select or enter value

Faculty First Name*

Faculty Last Name*

Faculty Email*

Faculty Department*

Does this preceptor have a current University of Colorado School of Medicine Faculty appointment?*

*If you select "no" or "I don't know" you may not participate in a clinical experience with this preceptor until you receive approval from the Office of Student Life.

Select or enter value

At what location is this experience taking place?*

Select or enter value

If you chose OTHER, what is the location?

Do you have a badge and EMR access to this site?*

Select or enter value

Estimated start date for Career Exploration*

Estimated end date for Career Exp (1 year max)*

Upload Approval Messages*

Please upload the following:

An email confirmation from the faculty member with whom you will be working that they approve of this experience and indicating that they have read and understand the Career Exploration Clinical Experiences policy that can be found in the school's Policies and Procedures. Please follow the instructions below to obtain this approval.

Copy and paste the text from this message into an email to your faculty member.
Upload the email approval from your faculty member's response.

Drag and drop files here or

Please add in additional information, if needed

Send me a copy of my responses

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