Psychiatric Nurse Practitioner and Physician Assistant

Clinic Training Program

ONLINE APPLICATION

Start My Wellness offers one-semester clinical training opportunities for individuals enrolled in a psychiatric nurse practitioner or physician assistant education program. To initiate the application process, please provide the following information:

"(Required)" indicates required fields

Contact Information

Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Email(Required)

Phone(Required)

Program Information

School Attended(Required)

Desired start date for clinical training (Month/Year)(Required)

Learning Objectives:(Required)

Completed Clinical Rotations (include setting and objectives):(Required)

Total Training Hours Sought at Start My Wellness:(Required)

Weekly Hours Available to Commit:(Required)

Preferred Model of Training:

In-Person

Virtual

Hybrid

No Preference

Upload Resume / CV(Required)

Please include a recent resume with this application which identifies all past degrees and certifications, schools attended, and prior work experiences.

Max. file size: 768 MB.

Spam Check - What is 11+5?(Required)