Observation Request

Student Observation Request

Applying to observe at Pediatric Connections OT is simple and convenient and consists of an online application that incorporates Privacy and Confidentiality (HIPAA) Training and the associated quiz

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The safety and privacy of patients and their families and staff is a top Pediatric Connections OT priority. The documentation that you are required to provide helps us ensure that every student observer understands our expectations. This is crucial to our efforts to protect every person involved in your educational experience.

Please follow the steps below to request your educational experience. Contact us with your questions at any point in the application process.

Please complete each of the following steps:

1. Click on and download the Privacy and Confidentiality Training document below to your computer
2. Read the Privacy and Confidentiality Training document
3. Complete Request for Observation form
4. You will receive a confirmation email once you have completed the form

7235 W 162nd Terr

Stilwell, KS 66085

info@PediatricConnectionsOT.com

Pediatric Connections

Tel: 913-257-5808

Fax: 844-270-5788

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