Educational Experience Request Form

To arrange an educational hands-on experience at UI Health Care, please complete and submit this form. We will do our best to accommodate your request, but we cannot guarantee the availability of requested experiences or dates.

Class/Group Information

Grade of Students

These interactive, hands-on educational health care experiences are geared towards students in 5th grade and older. If you have a group that is younger and submit a request, a staff member will contact you to discuss more.

Number of Students

Experiences are designed for groups. Therefore, we can not accommodate individual tours or groups with less than 5 students. A chaperone is required for all groups; at least 1 chaperone is required for every 10 students.

*Our sites are meant to be interactive and therefore accommodating more than 20 students may impede the learning experience of the students. Experiences will be limited as not all sites are available for large groups.

Special Accomodations

Individuals with disabilities are encouraged to participate in all UI-sponsored events. Do any members of the group need reasonable accommodations in order to participate?

Contact Person
Educational Experience

What week(s)/months do you prefer?

  • *Tours last up to 3 hours and do not include lunch. Students will need to eat prior to or following their visit.

    Preferred Educational Areas of Interest for Your Experience

    Please select up to 3 areas of interest. This will help us develop your educational experience