“A Day in Your Shoes” Exchange Sign-Up Form

“A Day in Your Shoes” Exchange Sign-Up Form
Thank you for your interest in participating in MHHC’s “A Day in Your Shoes” Exchange! Ever wondered what a day looks like in another role?

management and frontline staff will have the chance to switch roles for part of the day to gain new perspectives, strengthen teamwork, and build appreciation across departments.

Please complete the form below to participate.
Participant Information
1. Name*

First NameLast Name
2. Department*
3. Job Title / Role*
4. Are you:*

ManagementStaff
5. Which type of role are you interested in shadowing?*

Management / LeadershipFrontline / ClinicalFrontline / AdministrativeOpen to Any Role
6. Are there specific departments you’re interested in experiencing? (Optional)
7. Why do you want to participate in “A Day in Your Shoes”? *
8. Do you have any scheduling limitations on Tuesday, March 17?*

Morning OnlyAfternoon OnlyFlexible
Participation Agreement*

I understand this is a role-exchange/shadowing experience for learning and engagement purposes only.I agree to maintain professionalism and confidentiality during this experience.
Should be Empty:

Participant Information