Mammography/Breast Sonography Shadowing Form

Arkansas State University Mammography/ Breast Sonography Shadowing Form

Student Name: _______________________________________

This student completed a shadowing experience in the Medical Imaging Department at __________________________________ facility on _______________________ date. 

                                                                                                                                                                                      Circle one

1. The student was punctual and professional.                                                                                                Yes                   No
2. The student was prepared with questions and showed eagerness to learn.                                            Yes                   No
3. The student demonstrated good patient interactions and good communication skills.                          Yes                   No
4. The student had appropriate questions related to Mammography or Breast Sonography.                     Yes                   No 

Mammography Technologist or Ultrasound Technologist comments: 

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Technologist Signature: ________________________________________________

Student Section:
Discuss your shadowing experience.

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Student Signature: _________________________________________________  Date: ______________________________