Apprentice Application Form 🌟✨
Please fill out this form to apply for an apprenticeship with Dr. Hey and the Hey Clinic team. Ensure all required fields are completed and upload the necessary documents.
Personal Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Age
*
Home City & State
Current City (if different)
Education & Background
Status
*
Please Select
Undergraduate — Pre-Med / Health Sciences / Other major
Medical School (MD/DO) / PA School / Nursing School / PT-OT School / Pharmacy School / Other health professions
Gap year (pre-professional) / Other
School Name
*
Year / Level
How did you learn about the Dr. Hey apprenticeship?
*
Observation Request
Type of Observation
*
Please Select
Clinic only (Thursday & Friday)
Operating Room only (Monday–Wednesday)
Both clinic and OR
Summer Apprenticeship — Triangle area
Summer Apprenticeship + Shadowing
Preferred Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preferred End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Specific days & dates available
*
Your Story & Goals
Why do you want to shadow/apprentice with Dr. Hey?
*
What specific areas are you hoping to learn about?
Anything else you'd like us to know?
Forms Upload & Confirmation
Required Forms Upload (PDF, JPG, or PNG)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Please confirm the following:
*
Signed forms submitted
HIPAA requirements understood
Immunizations current
Professional conduct agreed
Submit Application
Should be Empty: