Health Sciences Internships

Internship course intent form

The intent form must be submitted and approved before starting an internship for credit. Failure to do so could result in denial of your internship for credit experience.

Once permission has been granted for the internship, you can register for the course, HLSC-H 495.

Fields marked with * are required.

Complete the HLSC-H 495 intent form

Complete the HLSC-H 495 intent form

  • Student Contact information

  • Student Name
  • Maximum of 10 characters allowed. Currently entered: 0 characters.
  • Campus
  • Cell Phone - -
  • Alternative Phone - -
  • On occasion, the department internship program is approached by the media, IUPUI Administrative Offices, or SHHS Marketing and Communications for interviews with current or past interns. Would you welcome these requests? (By checking yes, you are giving permission to share your contact information above with individuals from IUPUI or other media outlets.)
  • Internship information

  • Intern Supervisor Name
  • Supervisor Phone - -
  • Type of internship
  • Maximum of 300 words allowed. Currently entered: 0 words.
  • Maximum of 300 words allowed. Currently entered: 0 words.
  • List three objectives of your internship

    The objectives are what you hope to achieve or learn during the internship, not the specific job duties you will perform. For example, if you want to learn more about the work experience of a physical therapist, your objective could read, “Observe and learn about the daily routine of a Physical Therapist.”


If you have a question about internships in the Department of Health Sciences, please contact Kathy Berlin at