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Shadow Experience Summary/Questionnaire

Please take a few moments to share with us about your shadow experience. What worked well, what did not work very well? Tell us about your mentor. Did you receive valuable information, and how can we improve our process?

Date of Birth *:

Grade *:

Shadow:Experience Date *:

Did you enjoy the experience and did you leam things that you feel will help guide you toward a career decision?
YesNo

Did you feel welcome by your mentor during your shadowing experience?
YesNo

Did you feel the person you shadowed had a positive attitude?
YesNo

Do you feel like your experience was time well spent?
YesNo

Would you consider the job shadow provider for another shadow experience?
YesNo

Is there another area of healthcare you would like to shadow?
YesNo

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A non-profit Area Health Education Center (AHEC) operating in partnership with the University of Nebraska Medical Center, Nebraska AHEC Program Office.