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Job Shadow Release Form

Complete the job shadow release form to authorize participation in our program and gain valuable experience at Wisconsin Valley Veterinary Service.

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Job Shadow Release Form

Help us prepare for your visit by completing our job shadow release form. You can fill it out online or download it to submit at your convenience, allowing us to provide a meaningful experience from the start.

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Dress Code and Behavior

It is our desire that your time at our facility is educational and enjoyable. As a job shadow you will be representing Wisconsin Valley Veterinary Service through interactions with patients and clients, and you are expected to present yourself in a professional manner. Profanity or inappropriate conversations are not allowed. We expect all job shadows to wear appropriate clothing for the job in which you will be doing that day. Job shadows can wear business casual dress (scrubs, jeans without holes/patches, khakis, non revealing shirts, no shirts with inappropriate writing) while doing in-clinic rotations and barn appropriate attire for farm calls. Job shadows are not allowed to wear shorts, skirts, shirts that show mid drift, or tank tops. Open-toed shoes are also not allowed. Please dress smart, pay attention to the weather for that day and dress accordingly.

Medical Information

Medical Release

I, the undersigned (or parent/guardian), understand the nature of Wisconsin Valley Veterinary Service’s Job Shadow program and the activities involved, and state that the individual named on this form is in adequate health to perform, participate or observe the activities carried out in this program. I do ensure and guarantee to hold harmless Wisconsin Valley Veterinary Service, its staff, agents and representative from any responsibility for liability whatsoever resulting from the individual's actions, activities, or injury.

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Confidentiality Agreement

I, the undersigned (or parent/guardian), acknowledge that as a result of my association with Wisconsin Valley Veterinary Service, may have access to confidential information of the practice, including patient identifiable protected health information. I will hold confidential all patient and practice information obtained and will not disclose any personal, medical-related information, or any other confidential information to third parties during and after my time with Wisconsin Valley Veterinary Service. I am committed to protecting and safeguarding from any oral and written disclosure all confidential patient practice information of which I became aware.

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