Please Note: This form is NOT an application, but a registration form to initiate your registration process. This form is to be filled out by individuals who:
1. Have secured a visiting practitioner opportunity at OHSU
2. Are not participating in a clinical rotation required for their clinical degree or program
3. Were directed by the Office of Visitors & Volunteers to complete this form
If you do not meet the criteria above, please contact OVV@ohsu.edu for assistance.
If you are an international visitor of OHSU, please enter the US address you will be staying at for your contact information, and under the Emergency Contact section, enter a US emergency contact's information. Those without US SSN's may enter all "1s" (nine times - example: 111-11-1111) but must include secondary identification information (Visa/Passport).
Oregon Health & Science University values a diverse and culturally competent personnel community. We are proud of our commitment to being an equal opportunity, affirmative action organization that does not discriminate against individuals on the basis of any protected class status. Individuals with diverse backgrounds and those who promote diversity and a culture of inclusion are welcome.
In accordance with Federal Regulations, OHSU does not discriminate based on nationality or country of origin. This information is collected for Export Control regulatory compliance purposes only.