Ascension Texas Observer Program


This program is for observation only, no clinical participation is permitted by the observer.

This application is for the Ascension Texas Observer Program. The purpose of this program is to provide the observer with a shadowing experience to gain exposure and insight into the medical profession and specialty fields. Please be advised there is a $40 fee for background checks and a $10 fee for Ascension Seton Badges.


This program is NOT eligible to be used for course credit or a degree plan.

If you are seeking a program to gain access to Ascension Texas for an academic requirement, please contact the Academic Administration team at academicadmin@ascension.org.


Observer Requirements:

  1. Must have a sponsor secured and verified prior to applying. We do NOT match applicants to sponsors.
  2. Must be at least 18 years of age.
  3. Cannot be currently enrolled in High School.
  4. If the applicant is a physician, they must NOT be credentialed through the Medical Staff Office.
  5. If the applicant is a physician resident, they may NOT be employed by Ascension Texas(Seton or Providence)
  6. If the applicant is a current volunteer with Ascension, they must have completed 6 months of volunteer service prior to applying.



Application Process: Please read the steps before proceeding with the application. do not submit an application until you have the require components.

1.Fill out the application below.


2.In the Immunization History section, upload proof of the following as ONE PDF document:

  1. Hepatitis B: 3 vaccine series, positive titer or a signed declination.
  2. Measles, Mumps, Rubella (MMR): 2 vaccine series or positive titer.
  3. Varicella: 2 vaccine series or positive titer.
  4. Tetanus, Diphtheria, Pertussis(TDaP): DTaP or TD are NOT the same vaccine and will not be accepted in lieu of a TDaP.
  5. Influenza: vaccine required for observations occurring September through April
  6. TB Test: a negative IGRA whole blood assay (T-spot or TB Gold blood test) done 3 months or less before your requested start date. .

*TB Skin tests are no longer accepted *

  • In the event of a documented history of TB disease, documented previously positive TB test result or documented completion of treatment for LTBI or TB disease, the applicant must submit proof of a negative a Chest X-ray taken within the last 3 months.


3.Background Check: There is a required background check for this program with a $40 fee for US residents. The background check must be through our vendor and outside reports are not accepted. **There is no background check required for licensed physicians** In lieu of a background check, we verify the physician license.

For International applicants, the fee can vary from $40-$400 depending on the region. Please notify the program coordinator at TXObservers@ascension.org with your international address and we can provide a quote for the background check fee. International requests take 3-4 weeks to process.


Once your application is submitted you will be contacted with next steps for the background check.


4.Carefully read and attest to the attached documents regarding Privacy, Code of Ethics, Code of Conduct and Key Points.


5.SUBMIT the application


Applications can take, AT MINIMUM, 2 weeks for processing and longer if required components are not properly submitted.



For any questions, please contact the Ascension Texas Observer Program at TXObservers@ascension.org

 

Ascension Texas Observer Application

 

Enter the date of the procedure you will be observing or the date you hope to start your observation period.


We cannot guarantee you will be approved by your requested start date.

 
mm/dd/yyyy
 
 

The name as it appears on your legal documents

 
 
 
 

You must be 18 years of age to apply for the observer program.

 
mm/dd/yyyy
 
 
Phone
 

This question is required to help us determine the appropriate background check required for your request. It is not a factor in approving a request for observation.

 

Please explain why you are seeking an observation at Ascension.

 

If you do not have a current license in the United States, please answer "No".

 
 
 
 

Please enter the estimated number of hours you are requesting to shadow over the course of your 60 day approval period.

 
 

Sponsor Information

You must have an Ascension sponsor prior to applying for the Observer Program.

Your sponsor is the Ascension provider you will be observing. Please ensure you have communicated with this sponsor prior to applying. If you plan to observe additional sponsors, you must submit an Additional Sponsor Application for each additional sponsor. The link to this abbreviated application will be sent to you in a separate email.

 
 
 

Please indicate the sponsor's specialty/department. i.e. neurology, pediatric cardiology, rehab, etc.

 
 
 
 

Please indicate the specific units at your requested site, in which the observation will occur.

 

There is an additional sponsor/location application you will need to complete for EACH additional sponsor/location. Selecting Yes to this question will prompt an automated email with a link to that abbreviated application.

 

Observation Areas requiring Director Approval

Observations in the OR or NICU (neonatal intensive care unit) require a director approval. Please indicate if you will be observing in the OR or NICU.

DO NOT SELECT Yes unless you have confirmed with your sponsor that your observation will include a rotation in the OR or NICU. Doing so will cause a delay in your application processing.

 

Only select Yes if your sponsor has confirmed this option.

 

Only select Yes if your sponsor has confirmed this option.

 
 

Immunization History

Ascension Policy requires documentation of the following immunizations in order to comply with national requirements.

Please combine ALL documents and upload as ONE PDF.

Failure to submit proof of the required immunizations will delay processing and your application will be considered incomplete.

  1. Hepatitis B: 3 vaccine series, positive titer or a signed declination.
  2. Measles, Mumps, Rubella (MMR): 2 vaccine series or positive titer.
  3. Varicella: 2 vaccine series or positive titer.
  4. Tetanus, Diptheria, Pertussis(TDaP): given within the last 10 years, Diptheria, Tetanus and Pertussis or Tetanus/Diptheria are NOT the same vaccine and will not be accepted in lieu of a TDaP.
  5. Influenza: vaccine from current season.
  6. TB Test: IGRA(T-spot or TB Gold blood test) within 3 months of starting. *PPD Skin tests are no longer accepted by Ascension Occupational Health* In the event of a positive test a Chest X-ray done within the last 12 months will be required.
 

Badge Photo Submissions

Please UPLOAD a HEADSHOT photo for the badging office. Badge photos MUST include:

  • Image of you from the shoulders/chest to the top of your head
  • Normal to bright lighting
  • Clear face free of emojis, filters, excessive makeup or other objects obscuring your identity
  • Plain, light and/or bright background
  • Clothing without graphics or patterns
  • Professional Dress recommended


This photo will be used to make your badge ahead of your rotation. If your photo fails to meet these criteria, the creation of your badge WILL be delayed and you will be required to resubmit.

 

Please combine all Vaccine documents into ONE PDF and upload here.


Badge Photo Upload *

Please Note: If your photo does not meet all of the requirements, you will be asked to resubmit the image.

Drop your files here
 

Emergency Contact Information

Please enter information for the individual we should contact in the event of an emergency.

 
 
Phone
 
 
 

COMPLIANCE MODULES AND ATTESTATIONS

Upon submission of this application, you will be sent an email with a link to MyLearning Modules on required compliance topics. You must complete the modules and submit the certification of completion as part of the application process. The email you receive will contain additional details and information.

You must also read and attest to agree to the Observation Agreement and Observer Key Points below.

 
 

Observation Agreement

  1. I will make it my responsibility to know, understand, and adhere to the guidelines and procedures including completion of orientation and confidentiality training of each clinical facility.
  2. I will wear my Ascension Observer badge above the waist at all times while on site at an Ascension Texas facility. Instructions for obtaining your observer badge will be sent to you with your observation approval. The badge MUST BE RETURNED to the badge office upon completion of your observation period. Failure to return the badge can result in disqualification of future Academic experiences at Ascension.
  3. I will not enter any clinical facility except during the specified observational times agreed upon with my sponsor.
  4. Comply with the same PARKING regulations imposed on visitors at any Ascension facility.


DRESS CODE


  1. I am expected to exhibit and maintain a well-groomed personal appearance, including cleanliness and proper hygiene. Proper hygiene includes: clean teeth, hair and body with absence of body odor. Attire and personal grooming must satisfy all safety and health regulations and hospital policy.
  2. I will wear the appropriate, professional attire to ALL clinical facilities. Scrubs are not permitted unless observing in a surgical area. .
  3. I understand that I will be asked to leave the clinical facility if I don't comply with the dress code.
  4. I will wear my identifying nametag at ALL times while on Seton premises or while observing, and will promptly replace any lost or damaged tags. I understand for liability reasons that I may not participate in an observational experience if I do not wear my observer nametag appropriately.
  5. In consideration of our patients and others who may have sensitivity, minimal use of perfumes, after-shaves, and lotions are to be used.
  6. I will not eat, drink, or chew gum while in a clinical area.
  7. For infection control purposes, fingernails must be professional in length, color and must be neatly kept.


TOBACCO-FREE POLICY


A. Seton/Ascension is a tobacco free organization. This includes all tobacco types: cigarettes, chewing, and dipping.


B. Use of tobacco products, to include e-cigarettes (whether or not they contain nicotine), are prohibited on all Seton/Ascension grounds including sidewalks, parking structures, etc.


DRUG-FREE WORKPLACE POLICY


A. Seton/Ascension is a drug-free workplace.


B. The sale, manufacture, distribution, purchase, use, possession, or observation while under the influence of non-prescribed narcotics, hallucinogenic drugs, marijuana or other non-prescribed controlled substances is prohibited while on Seton/Ascension premises.


CODE OF CONDUCT


A. All individuals will abide by the Seton Mission Statement.


B. Demonstrate behavior that is appropriate for a professional healthcare setting.


C. In keeping with this behavior expectation, individuals must be honest in dealings with staff, patients, and families.


D. Obey clinical facility safety and security regulations.


E. Treat with respect the property of others.


F. Abide by all local, state, and federal laws while on premises.


G. THE USE OF CAMERAS, CELL PHONES, AND/OR HEADSETS IS PROHIBITED IN ALL PATIENT CARE AREAS.


H. I will comply with any instruction from the Sponsor immediately and without question while in the clinical setting.


I. I will not visit other units, nor will I leave the unit to which I am assigned unless authorized.


J. Illnesses and conditions I have observed will not be discussed with or in the presence of patients.


K. I will respect and properly care for all equipment and clinical supplies.


L. I will not make personal telephone calls, send text messages, take photos or make recordings, nor answer the phone in clinical areas unless so instructed.



OBSERVER HEALTH SCREENING


A. All observers should be free of communicable diseases that may be transmitted in the clinical facility.


B. If I am sick with a fever or have problems with rash or skin lesions, I will not be able to attend the observational experience in the clinical setting.


C. Contact the assigned Sponsor or the Ascension Academic Administration team with any questions.


D. All immunizations must be up to date and observer has a negative tuberculosis screening for active disease.


E. I must provide proof of seasonal flu vaccine if observation will occur during that time.



The following histories will disqualify an individual from consideration for the observational experience regardless of the date of the incident. I verify that I do not possess a criminal history or other conduct which places me in any of the following categories:


A. Health and Human Services - Office of Inspector General (OIG) List of Excluded Individuals/Entities


B. General Services Administration List of Parties Excluded from Federal Programs


C. Employee Misconduct Registry


D. U.S. Treasury - Office of Foreign Assets Control (OFAC) List of Specially Designated Nationals (SDN), Texas Health and Human Services Commission (TX HHSC) List of Excluded Individuals/Entities by Texas OIG


E. Sex Offender Registry


F. Felony convictions


G. Felony deferred adjudications involving crimes against persons (physical or sexual abuse)


I understand that if my conduct, behavior, and attitude are not satisfactory, my participation in this program will be immediately terminated.

 

By entering the date below, I attest and acknowledge that I have read, understand, and agree to comply with all the terms and conditions stated in the Observation Orientation Education throughout the duration of my observational experience at ANY Ascension location.

I understand that I must be with my Ascension designated Sponsor at all times during my observation experience.

 
mm/dd/yyyy
 
 
 

Observer Key Points

A. This program is not a shortcut around other programs' application process (e.g., residency programs, Texas State Medical Board certifications, etc.). This program will only be used on a limited basis and Observers will not participate or assist in any way. Observers will dress in work professional casual clothing to prevent the impression that they are practicing clinicians. Lab coats and scrubs should not be worn, except in the case of surgery observation. Observers are expected to present a professional, respectful demeanor always.


B. A non-recurring observation is limited to up to 60 days' total and may be less as determined by the Seton Office of Academic Affairs based on the type/purpose of the observation (This limit is intended to minimize the hardship that observation imposes on Seton patients or associates. Sponsors wishing to extend observation should appeal to the VP or Director for Academic Affairs and explain why extended observation is in Seton's best interests).


C. Observation will not be allowed for vaginal deliveries, except for Physician Observers Resident Observer or Ascension Observers, as appropriate.


D. Observation will not be allowed for trauma patients who have not had an opportunity to give their verbal and written consent.


E. Clinicians granted Observer status must not practice or provide professional services of any kind to include education and advising.


F. Under no circumstances will an Observer be allowed to observe without a Seton-approved observer badge. Once all other conditions have been met, verification is sent by the Seton Office of Academic Affairs to the Seton Badge office. The Seton-approved badge must be visibly worn above the waist always while on site.


G. If the observation occurs in the Operating Room, an Observer may not enter the sterile field or handle any device or instrument but they may be properly attired in scrubs to observe the sterile field. Observers in the operating room must present a signed sponsor form to the surgery director prior to observation. The OR staff must verify the observers cleared status prior to allowing observation.


H. At the completion of the approved observation dates, the observer must return the badge to the Seton Badge office. Failure to comply will result in future observation request being denied.

 

By entering the date below, I acknowledge and attest that I have read, understand, and agree to comply with all the terms and conditions stated in the Observer Key Points throughout the duration of my observational experience at ANY Ascension location.

I understand that I must be with my Ascension designated sponsor at all times during my observation experience.

 
mm/dd/yyyy
 
 

Next Steps: Application Fee and Sponsor Form Request

Application Fee: This application will NOT be processed until the $15 application fee is received.

Once you submit this application, you will receive an email confirming the submission of your application and providing the information required to submit your application fee.


Sponsor Form Request: In addition, once you submit this application, you will receive a pop up message with a link to submit an electronic sponsor form. Please follow the directions to submit this form. A signed sponsor form is required from EACH provider you are seeking to shadow/observe. This link will also be included in your submission confirmation email in the event your browser does not permit pop up messages. Please only submit this request once per provider/location.