Observership Application

Welcome to the application process for an Observership with UCHealth University of Colorado Hospital. We are committed to providing an enriching learning experience and are delighted to support you throughout the application process.

This application is for current UCHealth employees. To submit this application, you must have an active @uchealth.org email address.

Please note that observerships are limited to 30 consecutive days. We encourage you to work closely with your sponsor to ensure your proposed dates fall within this timeframe.

Before beginning your application, please gather all required documents. A complete list of required uploads can be found by scrolling down on this page.

We are pleased to support your professional development.

New User Details

User ID

User ID (verify)

Password

Password (verify)

Applicant Information

* First name

Middle initial

* Last Name

Preferred Name if different from First Name:

Preferred Pronouns

* Address:

Apartment #

* City:

State

* Country

Zip code:

* DOB (MM/DD/YYYY)

* Cell Phone

International Number

* Professional email ending in @uchealth.org:

* Please upload a photo of yourself.

Are you a United States Citizen?

If no, are you authorized to work in the U.S.?

Do you have a visa?

If yes, what type of Visa?

Education

Highest level of education completed

* Completed degree/subject

* School:

Are you a physician or APP at an academic medical center in the United States?

If yes, please list the name of the academic medical center.

Are you actively teaching at the academic medical center? Check box if yes.

Are you actively practicing clinically at the academic medical center? Check box if yes.

* What is your reason for pursuing an Observership? How will the information you acquire from this experience be applied?

Emergency Contact

Please provide the name, phone number, and email address of someone we may contact in case of an emergency.

* First and last name:

* Relationship

* Phone (Mobile)

International Emergency Phone Number (if applicable):

* Emergency Contact E-mail

Sponsor Department and Dates

* UCHealth Sponsor Full Name

* UCHealth Sponsor Department

* UCHealth Sponsor Title

* UCHealth Sponsor Email:

* UCHealth Sponsor Phone Number

Additional Department Contact Name:

Email for Additional Contact:

* Start of Observership

* End of Observership

Health Information Upload

For questions in this area, we highly encourage you to review our FAQs.

Please note: this is not an automated process. Please allow ample time for application and document review.

* U.S. issued ID or passport

* Copy of Health Insurance coverage for duration of visit to Colorado.

* Current CV or Resume

Observers's Signature

I certify that all responses on this document are true to the best of my knowledge. I agree that this information may be verified by UCHEALTH staff. I understand that any misrepresentation of information constitutes cause for separation or termination from Observership participation.

* Observership Applicant: Please type your name in this field as a form of electronic signature

* Observership Application Date

PHOTO CONSENT: This is to certify that I give permission to UCHealth to use my image for news media, marketing, public relations, and/or hospital business purposes.

* Observership Applicant: Please type your name in this field as a form of electronic signature

* Date:

After you click 'Submit' you will be redirected to the home page.

This is a good time to review all FAQs if you haven't done so already.

Next Steps: Please access your account and complete the online training modules, confidentiality statement, and waiver of liability. All steps must be completed at least 30 days prior to your observership start date. Following the review and approval of your initial application, a contract will be sent to you and your Sponsor.

Please watch for an email regarding the status of your application.

Please check your SPAM folder and add uchobserverships@uchealth.org to your contacts list to avoid missing our emails.