Visiting Learners Form

Guiding principles for Academic Year 2022-2023 are to protect patients, faculty, staff, and learners as well as to maintain a safe and effective learning environment. Clinical rotations for learners enrolled in Wake Forest University School of Medicine degree-granting programs will be prioritized. Please complete this entire form and a response will be provided as soon as possible. Also note that this is a smart form and will load more form fields based on your selections.

Please complete the following information and a response will be provided soon.

Learner Needs Information

WFBH will provide necessary mask(s) and/or gloves based on clinical assignment.

Home Institution Questions

These questions refer to the institution where the student is enrolled in their degree granting program.