Student Observation Application

Current degree you're pursuing in above school/program
Curriculum/Program Director
Email of above director
Phone number of above director
Is an internship required by your curriculum?
Note: We only accepte PA-C, PT, DO, MD & ATC for clinical rotations.
Number of observation hours being requested
Tell us about the experience you would like to have as an observer/intern at Andrews Sports Medicine & Orthopaedic Center.
Are you requesting to shadow a specific physician, staff member or specialty/profession?

Internship Start Date

What dates are you available/requesting for your internship/observation?

Internship End Date

Date you would wish internship to end.
One file only.
4 MB limit.
Allowed types: txt jpg jpeg pdf png.