The NSU shadowing experience form is a one-page document that the Certified Registered Nurse Anesthetist (CRNA) or Anesthesiologist you observed fills out and signs, and that you then upload to your NursingCAS application for Nova Southeastern University’s Doctor of Nursing Practice (DNP) Anesthesia program.1Nova Southeastern University. D.N.P. – CRNA Shadowing Experience Form The form is specific to the DNP-CRNA track within the Ron and Kathy Assaf College of Nursing. Other NSU health programs use their own observation paperwork, so make sure you have the right PDF before you print anything.
What the Form Asks For
The document is short. Above the signature block sits a confirmation statement with a blank for your name, stating that the applicant “has participated in a clinical observation experience with a CRNA or Anesthesiologist, during which they were introduced to the roles, responsibilities, and daily practice of the nurse anesthesia profession.”1Nova Southeastern University. D.N.P. – CRNA Shadowing Experience Form
The supervising provider then completes four fields:
- Name — the evaluator’s full name.
- Institution — the hospital, surgical center, or clinical site where the observation took place.
- Position — their professional role, such as CRNA or Anesthesiologist.
- Signature and date — handwritten or electronic.
There are no fields for total hours, specific dates, license numbers, or supervisor contact details. If you were expecting something that looks like a time log, this is not that form.
Where to Download It
Get the PDF directly from NSU’s College of Nursing forms page at nursing.nova.edu. The file is titled “D.N.P. – CRNA Shadowing Experience Form” and carries the header for the Ron and Kathy Assaf College of Nursing, Office of Graduate and Professional Admissions.1Nova Southeastern University. D.N.P. – CRNA Shadowing Experience Form Print it and bring it to the observation so the provider can sign the same day. Asking a busy clinician to complete paperwork weeks later, from memory, is how forms get delayed or politely declined.
What Counts as a Qualifying Observation
Only a CRNA or Anesthesiologist can sign the form. No other provider type satisfies the requirement. The stated purpose is exposure to the daily realities of nurse anesthesia practice so you can make an informed decision about entering the field.1Nova Southeastern University. D.N.P. – CRNA Shadowing Experience Form In practice, that means observing patient care activities in a clinical setting: pre-operative assessments, airway management, monitoring during procedures, and post-anesthesia recovery.
The form does not specify a minimum number of hours or sessions. A single brief visit is unlikely to give you much to say in an interview or the evaluator much to speak to. Time enough to see a variety of cases and have real conversations with the provider about the profession is the practical benchmark.
Before the session, confirm the provider is willing and cleared to host you. Some facilities require advance clearance through a compliance office. On the day, dress professionally, stay out of the sterile field, keep your phone away, and ask the provider up front how they want you to behave during cases — some prefer silence in the room and questions on breaks, others narrate as they work.
HIPAA Training for NSU-Affiliated Sites
Anyone observing clinical activities at an NSU-affiliated site falls under the university’s HIPAA compliance framework. NSU’s training matrix classifies visiting students in “observational only activities” as workforce members who must complete the NSU HIPAA Privacy, Security and Research Orientation before or within 30 days of the observation, and then sign the NSU Confidentiality Agreement for the Clinical Education Observer Form.2Nova Southeastern University. NSU HIPAA Training Requirements Matrix
The orientation runs three modules and takes roughly two hours. You access it through KnowBe4 via SharkLink. Failing to complete required training can trigger corrective action under the relevant program’s policies.3Nova Southeastern University. HIPAA Privacy, Security and Research Training Course Start it well before your visit rather than the week of.
If your shadowing is at a facility not affiliated with NSU, the site will likely have its own onboarding and confidentiality paperwork. Contact the office manager ahead of time to ask what they need. Either way, during the observation you will see protected health information. Never photograph, record, or discuss identifiable patient details outside the clinical setting, including in a personal statement without proper de-identification.
Submitting Through NursingCAS
Once the supervising CRNA or Anesthesiologist signs the form, they hand it back to you, and you upload the completed document as a supporting file within your NursingCAS application.1Nova Southeastern University. D.N.P. – CRNA Shadowing Experience Form NursingCAS is the correct destination. Not the NSU admissions portal, not AACOMAS, not AADSAS. Uploading to the wrong service means the DNP-CRNA reviewers never see it.
Before you upload:
- Scan at a resolution that keeps the signature and every field clearly legible. Blurry or cropped scans are an easy reason for a file to be flagged incomplete.
- Save as a PDF.
- Check that the applicant name written on the form matches your NursingCAS profile exactly.
- Keep a personal copy in case the upload fails or the program asks for a second one.
- Log back in a day or two after uploading to confirm the file shows as received.
A Note on Virtual Shadowing
NSU has offered virtual shadowing through partnerships such as Medi-Futures, including a program scheduled for Spring 2026.4Medi-Futures NSU. Medi-Futures NSU The shadowing experience form specifically references a “clinical observation experience,” and whether a virtual session satisfies that language for a given cycle is a question only the DNP-CRNA admissions office can answer. Ask before relying on virtual hours as a substitute for in-person observation.
Don’t Confuse It With the MS Anesthesia Form
The MS in Anesthesia program within NSU’s College of Allopathic Medicine uses a different document titled “Documentation of Exposure to Anesthesia Practice in the Operating Room.” That form requires at least eight hours of operating room observation and asks for specific dates, total hours, a daytime telephone number, and an email for the supervisor.5Nova Southeastern University. Documentation of Exposure to Anesthesia Practice in the Operating Room It is a different form for a different program. Don’t submit it in place of the DNP-CRNA form, or vice versa.
If you have questions about whether a specific observation experience will qualify, contact the NSU College of Nursing’s Office of Graduate and Professional Admissions at (954) 262-1101 or 800-541-6682.1Nova Southeastern University. D.N.P. – CRNA Shadowing Experience Form