Loading

PATIENT PORTALMAKE A PAYMENT SCHEDULE APPOINTMENT

CALL PROMISE

712-722-1700
877-722-1770

EMAIL PROMISE

care@promisechc.org

FIND PROMISE

33 4th St NW,
Sioux Center, IA

Menu

HOME
ABOUT PROMISE
+
NEW PATIENTS
SERVICES
+
PAYMENT OPTIONS
NEWS
- PROMISE PRAISES
+
CAREERS
+
CONTACT

PRECEPTORSHIP/STUDENT HOURS

HomeCAREERSPRECEPTORSHIP/STUDENT HOURS

Fill out the form below to request student hours.

Full Name*
Phone*
Home Street Address*
City, State, Zip*
School Email*
Personal Email*
College or University Attending*
Current Year in School?*
- Freshman
- Sophomore
- Junior
- Senior
- Master's Program
Requesting student hours in what department?*
- Medical
- Dental
- Mental Health
- Social Work
- Women's Health
Program/Licensure:*
- PA
- ARNP
- CNM
- LMSW
- PMHNP
- MD
- LMHC
Why do you want to be a midwife?
What are your personal experiences with midwifery?
Do you have a plan for after graduation?
What are your end-goals?
How many days and/or hours per week are you thinking for this rotation?
Are you interested in attending the homebirths with the midwives as well?
List dates/semesters you would need to get your student hours.*
example: spring semester 2025, January 20-May 1
Total hours requested*
example: 5 hours/week for 3 weeks OR 150 total hours
List any certifications you have received
Indicate any languages, other than English, that you are fluent in for speaking, reading or writing.
Do you know anyone at Promise CHC?*
- Yes
- No
If yes, who and what is your relationship to them?
PROFESSIONAL REFERENCE
Full Name*
Phone*
Title*
Email*
Describe your relationship to this reference*
Please specify which employee, college professor, etc that referred you.
Upload your resume here:*
Drop files here or
Accepted file types: jpg, png, pdf, Max. file size: 50 MB.
Correct and Complete*
By checking this box and submitting this electronic application, I affirm that all of the information that I have provided in the application is correct and complete to the best of my knowledge.

33 4th St NW, Sioux Center, IA 51250
Phone: 712-722-1700
Fax: 712-722-1770
Email: care@promisechc.org

PROMISE NEWS

2025 ADDINK COMMUNITY SERVICE AWARD RECIPIENT
Oct 13
0
SEPTEMBER IS SUICIDE PREVENTION AWARENESS MONTH
Sep 23
0
2025 DRIVE THRU FLU CLINICS
Sep 16
0

SUBSCRIBE TO PROMISE NEWS

First Name Last Name Email Address

This health center receives HHS funding and has Federal Public Health Service deemed status with respect to certain health or health-related claims, including medical malpractice claims, for itself and its covered individuals.

© Copyright Promise Community Health Center
Privacy Policy | OB Calendar | MAINTENANCE | PURCHASE ORDER | MARKETING REQUESTS | TRANSLATION REQUESTS | PROMISE PULSE |

This site uses cookies. By continuing to browse the site, you are agreeing to our use of cookies.

Español de México