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 first-time Observers. If you have previously completed an observership with UCHealth, please log in to your portal and apply for Additional Opportunities.

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 welcome you and look forward to supporting 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

* E-mail:

* 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

* Required immunization documentation (MMR, TDAP, Varicella) - completed immunization series or positive titers. MMR: measles, mumps, rubella: 2 step vaccination series TDAP: diptheria, pertussis, tetanus: multi step vaccination seriesVaricella: chickenpox: 2 step vaccination series 

Extra space to upload required vaccination records, if needed. 

* Hepatitis B

* TB test results (results of a negative TB test completed within the last 12 months)Acceptable TB tests include: Skin test (PPD), blood test (quantiferon gold), chest x-ray report

* Flu vaccination (October 1 through May 30) - for the North American flu season

* Results of Background Check in home country Provide a background check conducted within 6 months of start date. Background check includes:Criminal background check Last seven years of applicable countries, states and counties resided in and applicable name changes National sex offender listYou may need to request information from multiple countries 

* Excluded parties query of the General Service Administration's List of Parties Excluded from Federal Programs. This website is available to the public at https://oig/hhs.gov. Please visit the website provided. Click on Exclusions list. Search on searchable database. Look for your name. Screenshot the results.  Upload your screenshot here. 

Observers's Signature

As a participant in the UCHealth Observership Program, it is essential that all Observers are proficient in the English language to ensure the safety of our patients, the integrity of our clinical environments, and a respectful, effective experience for both our care teams and observers.

* I confirm that I can communicate clearly in English, both verbally and in writing. This includes understanding medical conversations, safety procedures, policies, and general communication from UCHealth staff and patients. I acknowledge that if, at any point during my observership, it is determined that I am not proficient in English and this is impacting safety, clinical workflows, or my experience, I may be removed from the program at the discretion of UCHealth University of Colorado staff.

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.