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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 SPs, or contact our Simulated Participant Coordinator, Leslie Nester at

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

If you are an Atrium Health employee, please complete the rest of the form. If not, please scroll to the submit button below.