Embedded Nursing Form | Carolinas Simulation Center

Please complete this application to help us determine if we can incorporate you into our educational activities. This information will be kept confidential and on file for current and future activities. Please keep in mind that all activities are short term and temporary. We will be in contact to discuss the program. You must be 18 years or older to apply.

If you have any additional questions, please see our FAQs for Embedded Nurses, or contact our Simulated Participant Coordinator, Leslie Nester at Leslie.Nester@atriumhealth.org.

NOTICE: We apologize for the inconvenience, but online applications are not currently submitting. Please email Leslie Nester at Leslie.Nester@atriumhealth.org to receive a PDF version of the online application. Thank you for your interest!

Full Name Address

Our sessions primarily take place at the flagship hospital of Atrium Health in Charlotte, NC. Do you live within an hour of this location? Yes No

Phone Number Email Date of Birth Languages Spoken (if any) How did you hear about us? What type of nursing have you specialized in and for how long? Why are you interested in working as an embedded nurse? Do you have any prior experience with health care simulation (including time as a learner)? Briefly describe your feelings about and experiences with physicians and other health care providers Carolinas Simulation Center is open Monday through Friday from 8 a.m. to 5 p.m., and any sessions that take place off site usually fall in that same time frame with a few exceptions. What's your availability during these hours? (days, hours, times of year) Upload a picture of yourself

If you are an Atrium Health employee, please complete the rest of the form. If not, please scroll to the submit button below. Department Name Job Title Department Manager Department Phone Employee ID#

Embedded Nursing Application

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