JOB SHADOWING AGREEMENT
Name of Candidate:
Enter your name
Name of CBHC QMHS Employee:
Enter name of person you are shadowing
Employee You Are Shadowing's Initials:
Enter the persons name that you will be shadowing
Please check all of the following basic mental health competencies that will be demonstrated during the job shadowing assignment:
An understanding of how to therapeutically engage a mentally ill person.
Concepts of recovery/resiliency.
An understanding of the community mental health system.
Understanding how their behavior can impact the behavior of individuals with mental illness.
I understand that job shadowing with a QMHS Worker from CBHC will require and entering personal homes.
Please type your initials
I agree that I will respect the patient's and their families' rights to privacy and will disclose any confidential information acquired as a result of my involvement during the Agreement of confidentiality and privacy of healthcare information reviewed and signed.
Please enter your intials
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