JOB OBSERVATION AT LMC

Thank you for expressing an interest in spending time at Lakeview Medical Center.

Please review, complete and return the documents linked on this page:

State of Wisconsin Disclosure Form

Policy and Procedure Packet:

  • Release and Waiver of Liability
  • Policy Acknowledgement
  • Health Information Report; Attach documented proof of health information OR have health care provider sign verifying information. Must provide medical documentation of vaccination, titer OR disease history OR combination for each item listed on the form.
  • Confidentiality Statement
  • Observational Experience Application form

Please allow 30 days for processing and approval of observation applications. An application will not be considered complete until all above items are received.

Completed materials can be scanned and returned via email, postal mail, or faxed to:
Lakeview Medical Center
1700 West Stout Street
Rice Lake, WI 54868
ATT: Tammy Koger, Volunteer Services Manager        

koger.tammy@lakeviewmedical.org

715-236-6255 (phone)

715-236-6461 (fax)