Firelands - Online Application for Rotation

Firelands Counseling & Recovery Services is an established provider of inpatient and outpatient behavioral health services. A full spectrum of mental health and chemical dependency services are available to help your transition through a time of crisis to a place of healing and recovery. Learn More

The Firelands Cancer Center provides cancer patients and their families with HOPE. Unlike anything in the area, the Center looks at cancer and its treatment through the eyes of the patient. And with its holistic approach, provides a complete program of comprehensive care for the whole family. Learn More

The clinics offered by Firelands Regional Medical Center are designed to meet the specific needs of our community. All clinics are staffed by our highly trained hospital staff. Learn More

Firelands Regional Medical Center's Corporate Health Center offers area businesses a comprehensive package of occupational and safety services tailored to each company's needs. Our goal is to help employers keep employees on the job. Learn More

The primary role of Diabetes Education is to provide an educational experience and the appropriate support systems for patients and families to learn the effective management of diabetes. Learn More

Whether you have been undergoing dialysis for some time or you are new to the procedure, Firelands Regional Medical Center will ease your fears and concerns with a special level of caring combined with leading edge technology. Learn More

Firelands Regional Medical Center's Digestive Health/Pain Relief/Pulmonary Center specializes in services for patients having gastrointestinal, pulmonary diagnostics, therapeutic and pain relief procedures. Learn More

Firelands Emergency Services Department is dedicated to providing the fastest and highest quality emergency care possible to our community 24-hours, 7 days a week. Our physicians and nurses are specialists in Emergency Medicine and certified in Advanced Trauma Life Support, Emergency Nursing, Trauma Nursing, Advanced Cardiac Life Support and Emergency Pediatric Care. Learn More

There have been many changes in health care recently. Firelands 55+ Club was formed to help our guests (ages 55 and older) to better understand and cope with these changes. This free program offers many services and important information. Learn More

Join Firelands in our commitment to helping the residents of the communities we serve to develop lifestyles that lead to a healthier tomorrow. Learn More

The Heart & Vascular Institute at Firelands Regional Medical Center offers services ranging from general cardiology and the treatment of chronic heart and vascular conditions to advanced surgical techniques, including open heart surgery. Providing award-winning care, Firelands Regional Medical Center has been named one of the nation's 100 Top Hospitals® for cardiovascular care by Thomson Reuters and also ranked in the top 10% in the nation for vascular surgery by HealthGrades. Learn More

Patients recovering from an illness or coping with a chronic health problem are apt to feel more at ease, and recover more quickly, in the familiar surroundings of home. Questions about your recovery, rehabilitation or care often arise along with the need for a helping hand and words of encouragement. To help with the transition from the hospital environment to the comfort of your own home, Firelands Regional Medical Center offers Home Health Services. Learn More

Wide ranges of diagnostic imaging procedures are available at Firelands. These services include diagnostic radiology, nuclear medicine, CT scanning, MRI, ultrasound, Angiography and PET. Additionally, Firelands has a Women's Health and Wellness Center where mammography, DEXA and select ultrasound studies are performed. Learn More

The Infusion Center was first established five years ago, when Firelands Regional Medical Center recognized the need for a designated area where physicians could send patients to receive infusion medications on an outpatient basis. Learn More

Laboratory services through Firelands Regional Medical Center are offered at various times and locations to meet the needs of the community. Learn More

Firelands Regional Medical Center is a leader in providing maternity and pediatric services to our community and surrounding areas. Learn More

Neuropsychological services at Firelands Regional Medical Center provide consultation and evaluation to inpatients and outpatients ages 18 years and older (adolescents approved on a case-by-case basis) with a broad range of conditions. Learn More

One of the most important missions of physicians everywhere is to relieve their patients' pain and suffering. Doctors have worked for thousands of years with a variety of treatments, techniques and medications to find the most effective methods to address pain. They focus on studying pain, what causes it, how we react to it and how to dull or eliminate pain. This mission has created a new category of medicine known as Pain Management. Learn More

Firelands Regional Medical Center’s Department of Pharmacy Services consists of state-of-the-art facilities and decentralized satellites to provide pharmacy services across the continuum of care. Our pharmacists play an integral role in the recommendation of medications; patient counseling and evaluation; and consultation with physicians and nurses to promote best practices. In addition to our tireless pursuit of medication safety and best practices, we offer a variety of services that are listed below. Learn More

Firelands offers extensive therapy services for our patients in need. These services, available on both an inpatient and outpatient basis, are designed to help our patients achieve optimal functioning in their daily activities and lead a productive and fulfilling life. We also help both patient and family adjust emotionally and socially to the changes that occur as a result of any disability. Learn More

Our goal is to provide high quality and efficient pulmonary diagnostic and respiratory therapeutic care for all patients requiring pulmonary services. Under the direction of a Pulminologist, respiratory services are administered on both an outpatient and inpatient basis. Learn More

One in three people are affected by a sleep disorder at some point in life. Too often sleep problems are ignored or assumed to be psychological in origin. Better testing procedures have revealed new information on sleep-wake disturbances resulting in greater understanding and more successful treatment. Firelands Center for Sleep Disorders provides help for those suffering from sleep problems. Learn More

Firelands Regional Medical Center provides the area's most advanced neuroscience services. The program provides integrated care in the treatment of all neurological and musculoskeletal systems. Utilizing a team approach, the program offers inpatient and outpatient physical medicine and rehabilitation services to children and adults. Learn More

There are four different types of surgery available at Firelands Regional Medical Center: outpatient, ambulatory, same day and inpatient. Your physician will decide which surgery is appropriate for you. Learn More

At the Firelands Women's Health and Wellness Center, we understand the unique healthcare concerns of women and are dedicated to meeting their specific diagnostic needs. Our total care program includes screening, diagnostics, education and consultation. Learn More

If you have a wound that won't heal, you are not alone. Approximately three to five million Americans experience this condition. The good news is that you no longer have to suffer. The Firelands Wound Care Programs specializes in treating chronic or non-healing wounds, defined as sores or wounds not showing significant improvement with conventional treatment. Learn More


Personal Data
Full Name:
Present Address:
Present Telephone:
Home Address:
Home Telephone:
E-mail Address:
Date of Birth:
Social Security #:
Marital Status:
AOA#:
Race/Ethnicity (Optional):
Citizenship / Country:
Gender:	Male: Female:

Medical School Information
Medical School:
City:
State:
Date of Graduation (anticipated):

Elective Rotation Information
#1 Rotation Desired:
Start Date:
End Date:
Housing Required:	Yes: No:
#2 Rotation Desired:
Start Date:
End Date:
Housing Required:	Yes: No:
#3 Rotation Desired:
Start Date:
End Date:
Housing Required:	Yes: No:
#4 Rotation Desired:
Start Date:
End Date:
Housing Required:	Yes: No: