Physician Shadowing Application

- OCTOBER 24, 2023
October Is Also a Time for Liver Cancer Awareness
While most people are aware that October is a time to bring awareness to breast cancer, many do not realize it is also a time set aside to learn more about liver cancer and honor those who have been affected by it. Liver cancer appears in patients as either primary, meaning cancer originates in the
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- OCTOBER 9, 2023
Lawson Cancer Center Celebrates Grand Opening of Long-Awaited Expansion Project
On Monday, September 25th, the first patients were welcomed into the brand-new expanded space at the Lawson Cancer Center (LCC) on the 11th floor of the Pikeville Medical Center Clinic Building. On its first day open, 15 patients received specialized care in the 24 additional treatment rooms created by a nearly $5 million grant from
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- MARCH 24, 2023
PMC Now Offering Pet Scans to Target Prostate Cancer
On March 10, 2023, the Pikeville Medical Center (PMC) Diagnostic Center team reached another milestone by performing the region’s first PET scan designed specifically to detect prostate cancer. PMC can now perform a specialized scan that detects cells indicating prostate cancer. The risk of developing prostate cancer increases as men age. Second to skin cancer,
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- DECEMBER 20, 2022
PMC Receives 2023 Women’s Choice Award as One of America’s Best Hospitals for Cancer Care
Range of treatment services, low infection rates cited in award recognition Pikeville Medical Center (PMC) has been named one of America’s Best Hospitals for Cancer Care by the Women’s Choice Award®, America’s trusted referral source for the best in healthcare. The award signifies that PMC is among the top U.S. hospitals offering cancer care services.
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First Name:
Middle Name:
Last Name:
Are you 16 or older?	Yes No
Date of Birth:
Home #:
Cell #:
Email Address:
Present Address:
SSN:
Timeframe of shadowing request:
Emergency Contact:
Name:
Phone #:
I represent and warrant that I am not now nor have I ever been (i) listed by an agency or entity as excluded, debarred, suspended, or otherwise ineligible to participate in any federal, state, or private health care benefit program; (ii) listed as an excluded party by the U.S. Department of Health and Human Services or General Services Administration; (ii) been charged with, convicted of, pled guilty to, or entered a plea of non contendere (or any similar plea) with respect to any healthcare related offense; or (iv) been sanctioned for any form of healthcare fraud or abuse. I will notify Pikeville Medical Center immediately upon the commencement of any proceeding against me in which the outcome may be any of the above-described events. I further agree to execute any documentation necessary to comply with PMC’s vaccination policy, including any authorizations to release my protected health information or otherwise apply for an appropriate exemption. I agree that before I can be accepted as a physician shadow I must comply with PMC’s vaccination policy and failure to comply may lead to me not being accepted as a physician shadow or being dismissed as a physician shadow. I hereby attest that all of the foregoing information is true and correct. I authorize Pikeville Medical Center to obtain such background and personal reports as are deemed necessary to verify that the information I have supplied is true and accurate. A copy of this authorization is valid as the original.
Participant Signature:
Date:
If younger than 18 years of age, please have a Parent/Legal Guardian read and sign the following: I hereby attest that I am the Parent/Legal Guardian of the Applicant and that all of the foregoing information is true and correct. I authorize Pikeville Medical Center to obtain such background and personal reports regarding the Applicant as are deemed necessary to verify that the information I have supplied is true and accurate. A copy of this authorization is valid as the original.
Parent/Legal Guardian Signature:
Date:

Latest News and Events

October Is Also a Time for Liver Cancer Awareness

Lawson Cancer Center Celebrates Grand Opening of Long-Awaited Expansion Project

PMC Now Offering Pet Scans to Target Prostate Cancer

PMC Receives 2023 Women’s Choice Award as One of America’s Best Hospitals for Cancer Care

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