Nursing Student Mentor Program Application

 If you are a college student, working towards a BSN or ADN, and are interested in taking
advantage of our mentor program, please fill out the below application and submit.
 
First Name:  
Last Name:  
E-Mail:  
Phone:
City, State, Zip:
Current Year In School:
Why did you decide to study towards a nursing degree?

Please indicate the particular managed care area(s) in which you are interested:  (Click all that apply)

 

 Fundamentals of Managed Care
Career Guidance
Case Management
Disease Management
Utilization Management/Review
Appeal Management
Quality Improvement/Performance Improvement

Patient Education
Research
Reporting
Leadership
Technology/Internet
Medicare/Medicaid Managed Care