Medical Students Clinical Rotation Request

Request type:

Answer the question below:
= four + two

Documents to Upload

Initial Request
Once Approved
  • All students must provide proof of the following:
    1. Current immunizations/immunity documentation:
      1. Measles, mumps, and rubella (MMR): 2 does of MMR – OR – positive lab titers showing immunity for measles, mumps and rubella
      2. Tuberculosis (TB): Negative TST test within the last 12 months
      3. Hepatitis B: completed 3 shot series, or positive antibody titer
      4. Influenza: Updated for current flu season (Oct 1 – March 31)
    2. Malpractice or coverage letter for the school
    3. Current Copy of BLS/ACLS certification
  • Students need to complete all forms
    1. Orientation checklist (PDF)
    2. Confidentiality form (PDF)
    3. Living our Mission Signature form (PDF)