If you are an employer and have an externship available in your healthcare facility, please fill out the form here and the Medical Assisting Coordinator will get in touch with you.

Externship Request Form

Facility Name *

Website URL: *

Your Name: *

Title: *

Email Address *

Phone *

Street Address

Address Line 2

City *

State *

Zip Code *

Thank you for your interest in our students. This application form will be sent to the Medical Assisting Coordinator.