Practice Site Description * RequiredInterprofessional Clinical Practice Team – InpatientInterprofessional Clinical Practice Team – OutpatientInterprofessional Research TeamInterprofessional Policy/Regulatory TeamOtherPractice Site Description: Other * RequiredSite/Activity Name: * RequiredLocation: * RequiredDays and Hours available to shadow: * RequiredResearch Focus or Population(s) Served: * RequiredInterprofessional Team Members in this activity: * RequiredPlease describe the activity a student will observe in a few sentences: * RequiredAre you willing for this site to be available for students to set up a shadowing appointment? * Required Yes No If Yes above, please provide a contact person for students to schedule a shadowing appointment:Name First Last PhoneEmail Thank you for hosting an IPE student and serving as an integral component in the Interprofessional Educational experience for our future health and science professionals! Please contact the Office of Interprofessional Education (OIPE) at ipe@uams.edu if you have any questions about this form or about Exposure phase shadowing expectations.
