Clinical Health Requirements and Background Checks
Clinical health requirements and background checks are mandatory per the clinical facilities for any student participating in clinical courses. The facilities will not allow anyone entry unless the College of Nursing and Health Sciences can provide documentation each semester that all of the requirements have been met. All health requirements are determined by each individual facility and are subject to change without prior notice. We attempt to notify students and meet these specific requirements as quick and smoothly as possible. However, the students are liable for maintaining current and accurate health records during the entire time participating in clinical courses.
We are implementing a new system for tracking health records that will be more secure and easier for you. Effective immediately you will be able to email, fax or mail your health records to Certified Background. All nursing students must submit their health records to this web site by the health records deadline.
Summer term 2013 health records deadline: April 5th, 2013
Fall term 2013 health records deadline: July 5th, 2013
Attention!: If your health requirements expire during the term you are entering, you must submit a new one by the health records deadline for that term!!
Click on the link to view the list of all the clinical health requirements.
You can address your questions and concerns to the Health Record Assistant, Risa Tokashiki, at firstname.lastname@example.org or by phone at 236-5816.
Her office hours are:
Monday to Friday from 8 am to 5 pm
***Some clinical site may ask for additional testing, and fees may be required.***
Click on the links to access, fill and print the following forms:
- Certified Background Student Instructions
- Clinical Health Requirements
- Confidentiality Statement
- Declaration of Fitness and Background Check
- Health Care Provider Letter
- Health Care Provider List
- Health Insurance Intent Form (Fall 2013)
- Health Insurance Intent Form (Summer 2013)
- HIPAA and Blood Borne Pathogens Instructions
- Influenza Vaccine Form
- Physical Exam form
- SSN Form
- TB Monitoring Questionnaire
- TB Monitoring Questionnaire (TB shortage: Only for students that receive annual TB testing)
Updated on: 04/2/2013