Clinical placement at CMG is not guaranteed for any student
Currently there are more student requests than providers available to teach. Clinical placement decisions are based on multiple criteria. Priority placement is given to CMG employees and students that are seeking to establish a practice in rural Idaho. See application instructions below for application tips. 

Application Deadline
60 days prior to rotation start date.

Affiliation Agreement
A current affiliation agreement must be in place between your university and CMG. To confirm if there is an agreement please contact your school coordinator. 

Contacting Providers and Staff
Do not send mass communications to providers or staff at CMG requesting clinical placement. If you know a provider professionally or personally and would like to schedule a rotation with them please indicate their name on the application. CMG will verify if the provider is available. Submission of your application signifies agreement with this stipulation. 

Application Instructions
The purpose of the application is to facilitate a comprehensive experience for students and providers. Submit an application for each rotation you would like to complete at CMG. Remember to update the required objectives for each application to clearly identify the purpose and goals for each rotation. 

Application Tips
-Include all clinical areas where you can complete your rotation.
-List any providers you know or would want to work with for your rotation. 
-Be sure to double check dates and school contact information for accuracy. 
-Do not leave questions blank. Use n/a or unknown if applicable.

Student Coordinator
Kary Lockart
208-298-3093
klockart@valleymedicalcenter.com


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* 1. Is financial reimbursement offered?

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* 2. Who is completing this request?

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* 3. Student Contact Information

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* 4. Emergency Contact

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* 5. What type of program are you in?

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* 6. What year will you be for this clinical?

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* 7. Are you currently employed at CMG?

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* 8. University Information

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* 9. Univeristy Student Coordinator Contact Information

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* 10. Specific dates of your clinical rotation (an application is needed for each rotation)

Date
Date

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* 11. Total hours needed during this rotation:

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* 12. Select all areas or population of preference for this clinical rotation (read your program requirements carefully to indicate qualifying  areas for your rotation). 

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* 13. Please list any providers you would like to request as a preceptor: Placement with a specific provider is not guaranteed. Please do not contact providers directly. 

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* 14. Please provide a summary of student requirements for this clinical. What they can and cannot do. Syllabus if possible. 

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* 15. Please indicate the information your university needs from your preceptor:

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* 16. Provide letter of introduction in the text box below including the following information: professional background, strengths, and career goals. Where do you call home? Where do you plan on practicing after graduation? What makes you an ideal candidate for this clinical placement and possible future employment at CMG?

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