What goes on a CRNA shadowing form?

Your name, the facility, the date or dates, your total hours, and the provider's name, credentials, contact information, signature and date. Some school forms ask for more. AdventHealth's verification form also asks for the types of surgeries and anesthesia you saw and whether you were present for the preoperative assessment, induction, maintenance, emergence and PACU handoff. Leave every patient detail off the form.

Do I have to use the school's own shadowing form?

Yes, whenever the program supplies one and asks for it. AdventHealth requires its completed Shadow Verification Form, while UIW says you may use its program form to document your shadowing and upload it to NursingCAS. If a school doesn't provide a form, ask admissions whether a general signed log works before you rely on one. Never edit another school's form to look like your target program's.

Can an anesthesiologist sign my CRNA shadowing form?

At some programs, yes. AdventHealth's form verifies shadowing with "a practicing certified registered nurse anesthetist (CRNA) or physician anesthesiologist." Other programs specifically ask for CRNA observation, like UIW's admissions page , which says to arrange shadowing with a CRNA. Read each target program's wording, and if you want hours that count everywhere, shadow a CRNA and have that CRNA sign.

How do I count hours on a CRNA shadowing log?

Log your actual start and end times, then subtract anything the program doesn't count, like a break. A 7:00 a.m. to 3:00 p.m. day with a 30-minute break is 7.5 observation hours, not 8. Some programs also set how the hours are spread out. AdventHealth wants 24 hours as three 8-hour or two 12-hour shifts within one year of the application date. Never round up to hit a minimum.

What if I forgot to get my shadowing form signed?

Contact the CRNA you actually shadowed, give them the date and hours, and ask whether they'll verify it now. Then check whether your program accepts later verification and how it wants the form submitted. Don't sign it yourself, backdate it or ask someone who wasn't there. To avoid this next time, mention the form when you schedule the day and bring it with you.

How do I submit a CRNA shadowing form?

Exactly the way the program says, whether that's a NursingCAS upload, a school portal or an admissions email. UIW's form says to submit it with your application materials to NursingCAS or to the program's email address. If a provider has to send it directly, your own copy doesn't complete that step, so track whether the program received it.

CRNA Shadowing Form and Log: Template, Hours & Verification

Your CRNA shadowing form records what a provider can verify: your name, where and when you observed, your actual hours, and the provider’s details and signature when they’re required. If your target school supplies its own form, use that one. A general log is great for organizing your records, but it can’t stand in for a required school form or a direct submission.

Keep attendance verification and reflection in two separate places. The first shows what you completed. The second helps you remember what you learned. And neither one needs patient names, record numbers, photographs or identifying case details.

Which fields belong in a shadowing log?

Start with the minimum information it takes to connect you, the visit and the person who can verify it. Add a field because the school or facility asks for it. A template happening to include it isn’t a good enough reason.

Field	What to enter	Check before recording
Observer name	Your name as used in the application	Whether the school requires an applicant ID
Observation date	The actual date of the visit	Whether separate dates require separate forms
Facility and general setting	Facility name and broad area, such as main OR	Facility policy on recording location information
Start, finish, and breaks	Actual attendance times and any excluded periods	How the receiving school wants hours calculated
Total observation hours	The supported total after applicable exclusions	Don’t round up to reach a minimum
Provider name and credentials	The person you actually observed	Whether the program requires CRNA observation or accepts another provider
Verification contact	Professional contact the provider authorizes you to use	Don’t collect private details unnecessarily
Provider verification	Signature and date, if requested	Required format and submission route

The AdventHealth University anesthesia shadowing form asks about the setting, hours, provider and phases of anesthesia observed. The University of the Incarnate Word form includes a provider attestation and submission instructions. The two forms differ, and neither one tells you what every school accepts.

You might also want a separate personal tracker showing which application got each form. That way a signed document doesn’t get mistaken for a finished application requirement.

When must I use a school’s own form?

Use it whenever the program tells you to. Download the current version before your observation day and read the instructions, including who may verify the experience and where the completed document has to go. A form signed by the wrong type of provider may not meet the program’s rule.

Check four details before the visit: the required provider type, any minimum or recency rule, the required signatures and the submission method. If the instructions are unclear, send the admissions office a specific question. Don’t edit their form yourself.

For example: “Your application asks for a signed shadowing verification. I observed a CRNA on two dates at the same facility. Should I submit one form with both dates or a separate form for each visit?”

If no form is supplied, ask whether a general signed log is acceptable. Don’t strip another university’s logo off its document and present it as a form your target school approved. Your own general log should be honest about what it is.

A copyable general shadowing log

The template below is a planning aid. It isn’t a universally accepted admissions form, so drop or add fields based on the receiving program’s instructions. Your host should verify only what they can actually confirm.

CRNA shadowing attendance record

Observer name: ____________________________________

Facility and general setting: ________________________

Observation date: __________________________________

Start time: __________ End time: __________

Excluded breaks or non-observation time: _______________

Total verified observation hours: ______________________

Provider name and credentials: ________________________

Professional verification contact, with permission: ________

Broad activities observed, if requested: __________________

Provider confirmation of the dates and hours above: ________

Provider signature and date, if required: _________________

Submission destination and method: _____________________

Keep any admissions-specific evaluation separate unless the school’s own form combines it with attendance. A signature verifying your hours isn’t automatically a recommendation, and it isn’t an endorsement of your readiness for graduate education.

If you’d rather use a spreadsheet, these column headings work well:

Observation date,Facility,General setting,Start time,End time,Excluded minutes,Verified hours,Provider name,Credentials,Authorized professional contact,Required form,Verification status,Submission status

Don’t put patient information in a spreadsheet, a filename, an email subject or free-text notes. A handy personal cloud folder doesn’t give you permission to store clinical information there.

How do I document dates and hours accurately?

Record your actual attendance, then apply the school’s rule about what counts. If the program doesn’t count a break, an orientation period or travel time, list it separately. And if the policy doesn’t say, ask. Don’t decide on your own that every minute at the facility qualifies.

Fictional calculation: A visit runs from 7:00 a.m. to 3:00 p.m., with a 30-minute break that doesn’t count under the example’s assumed rule. Elapsed time is eight hours. Observation time is 7.5 hours. If a school requires eight qualifying hours, rounding 7.5 up to eight wouldn’t complete that requirement.

The exclusion in that example is illustrative. It isn’t a universal rule that all programs subtract the same break or accept the same activities.

For multiple visits, keep a separate row for each date and check your totals against the signed records. Don’t count the same hours twice because two documents describe the same day. If you find an error after the form’s been signed, ask the provider and the receiving school how to correct it. Never alter a signed attestation on your own.

Who can verify attendance, and what if I forgot a signature?

Follow the program’s named verifier requirement. The person you shadowed can usually describe what they directly saw of your attendance, and a school may specify a signature, credentials, a professional contact or direct submission. Don’t ask another clinician who wasn’t there to attest to the day.

If you forgot the form, contact your actual host with the date and a factual explanation. Ask whether they can verify the record and whether the school allows later verification. Don’t fill in a signature, backdate a document or assume the hours are either invalid or accepted before you hear back.

You can make this easier by bringing up the form when you schedule. At the end of the visit, check whether your host has a good moment to review it. Patient care still comes first (so if the day gets busy, agree on a later process instead).

What patient information stays out, and how should I submit the form?

Document your attendance and what you learned without identifying patients. Keep reflections broad. “I learned how the team organizes a transition in care” is enough to remind you of a lesson. A detailed account of an unusual case can identify someone even without a name.

Follow the facility’s observer restrictions and the program’s actual submission instructions. Don’t photograph a chart or a monitor to jog your memory. And don’t put a patient’s name on a form that’s headed to admissions.

Store a legible copy of the attendance document securely, with access limited to the people who need it. Send it through the required application portal or another approved route. If the provider has to submit directly, your saved copy doesn’t complete that step. Track receipt instead of assuming the upload went through.

For help setting up the visit, see how to find CRNA shadowing. For the requirement behind the form, check shadowing-hour policies against each target program. You’re aiming for a clear, truthful record that meets the actual instructions the first time.