Job Shadow: Supervisor Support Form
Prior to the job shadow, managers must approve the job shadow by signing the Employee Manager section below.

Employee
Please fill out top three lines and give form to your manager at the Hospital. Have them complete this form and return it to you before your job shadow experience can be initiated. Turn this form in to the internal Health Careers Specialist or Salem Hospital HR.

Employee Name:_______________________________________________________________

Current Job Title and Department:__________________________________________________

Department and Career of Interest:_________________________________________________

Employee Manager
Please complete and sign the section below. By signing below you are indicating you support the employee above to participate in Career Development efforts. Once you sign the form please return it to the Employee. Thank you for your time and assistance with the Career Exploration Program!

Manager Name:___________________________________________________________

Manager Signature:________________________________Date:____________________

Job Title and Department:____________________________________________________ 

Comments regarding best days and times for employee to participate in the Job Shadow Experience given employee’s current work schedule.

Comments regarding bad days and times for employee to participate in the Job Shadow Experience given employee’s current work schedule.