Job Shadow Application

Before you begin this application, be advised that Aspirus has certain immunization requirements and you need to provide the dates you were immunized for the following:

  • Last two TB skin tests/blood draw showing a negative result or TB skin test/blood test showing a positive result. The most recent result must be within the past 12 months.
  • Last two MMR vaccinations, MMR titer showing immunity, or explanation of incomplete vaccination series.
  • Last two Varicella vaccinations, Varicella titer showing immunity, or explanation of incomplete vaccination series. Aspirus does not accept “History of Disease” as proof of immunity.
  • Hepatitis B vaccination status or Hepatitis B declination.
  • Flu vaccination proof or declination. Please note: Indicating you have received your flu shot will require you to upload documentation showing proof. Be sure to have the file on your device prior to beginning the application.
  • COVID-19 vaccination proof or declination. Please note: Indicating you have received your COVID-19 vaccination will require you to upload documentation showing proof. Be sure to have the file on your device prior to beginning the application.

This information is often not common knowledge, so you may need to contact your physician’s office or obtain a copy of your medical record. You are encouraged to have this information before starting the application, as you will not be able to save your progress.


SCHOOL INFORMATION

* Denotes required field


STUDENT INFORMATION


PLACEMENT INFORMATION











HEALTH HISTORY




IMMUNIZATION REQUIREMENTS

Aspirus has certain immunization requirements. To complete the information below, you may need to contact your physician’s office or obtain a copy of your medical record.





Dates of two most recent TB skin tests showing a negative result:





MMR vaccination series dates





Varicella vaccination series dates













ONBOARDING DOCUMENTS REVIEW

Please open, save and then review the documents below as a condition of your placement with Aspirus.


SIGN-OFF

Once you have reviewed the onboarding documents above, please check the box below indicating your compliance with our student onboarding procedures.


ADDITIONAL COMMENTS


Step 1 of 2. Next: Confirm & Submit