Visiting Trainee Rotation Request Form - Legacy Health 2026

1. Click ‘Get Form’ to open the Visiting Trainee Rotation Request Form in the editor.
2. Begin by filling out the 'Visiting Trainee Information' section. Enter your last name, first name, middle initial, date of birth, and social security number. Ensure all information is accurate for processing.
3. Complete the contact details including your cell number, pager number, and email address. This information is crucial for communication regarding your application.
4. In the 'Home Institution' section, provide the institution's name, address, coordinator's name, email, and phone number. This verifies your current educational affiliation.
5. Fill out the 'Rotation Information' section by selecting your desired Legacy rotation site(s) and preceptor from the dropdown menus. Specify your rotation start and end dates.
6. Complete any additional fields such as prior Epic experience and specialty. Make sure to answer questions regarding your academic standing accurately.
7. Finally, review all entries for accuracy before submitting. Once completed, save or export your form directly from our platform for easy submission.

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