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1407 Whisenant Duncan, OK 73533
Phone: (580) 252-5300
US Hwy 81 & US Hwy 70 Waurika, OK 73573
Phone: (580) 228-2344
We offer a variety of community resources designed to assist you in maintaining your health and safety.
Home / Patients & Visitors / Forms / Job Shadow Application
I understand it is my responsibility to provide DRH Health with my current immunization records such as Measles, Hepatitis B, Mumps, Rubella, Influenza, and Chicken Pox (Varicella).
I also understand a current Tuberculosis skin test (PPD) is required along with complete COVID vaccine and flu vaccine for this season as required by DRH Health.
I have read and understand the information given. Should I need medical attention during or as a result of this job shadowing experience, I assume full responsibility for any treatments deemed necessary. I assume responsibility of all medical costs which result and release DRH Health of all liability. I give the facility at which job shadow is being conducted permission to release my telephone number or contact information to the requested department. While I am job shadowing at any DRH Health site, I realize that all healthcare information, patient/resident care and records are a confidential matter. All information exchanged while I am observing must be held in strictest confidence. I will only observe patient care and the role of the healthcare provider.
I have read and understand the information given and authorize my son/daughter to participate in this job shadowing experience. DRH Health shall not be held responsible for adverse occurrences and/or outcomes. Should my child need medical attention during or as a result of this job shadowing experience, I authorize such medical care and assume full responsibility for any treatments deemed necessary. I assume responsibility for all medical costs which result and release DRH Health of all liability. I give DRH Health permission to release my son/daughter telephone number or contact information to the requested department.