With outpatient clinics, just call around and ask or send emails to different facilities. If you're having issues with large chains, maybe try some smaller independent clinics. You may have to drive a bit in order to find a place that will allow shadowing. As the above poster said, inpatient will be much more difficult. With inpatient, I sent emails to about 10 different skilled nursing facilities and only heard back from one. The hospital I shadowed at was also very difficult to hunt down the contact info and then I had to have a TB test and flu shot done in order to observe.