Clinical Track Forms

Clinical Courses & Preceptor Information

Tips for finding a preceptor

Exxat Instructions

Typhon Instructions

COVID:  Assumption of Risk Form

Clinical Site Evaluation Form

Clinical Evaluation of Preceptor by Student

Drug Screening and Testing

Grad Nursing Clinical Checklist-EXXAT

Grad Nursing Clinical Checklist - TYPHON

Clinical Student Request & Authorization to Release Records and/or Info.

Initial Clinical Health Clearance Form

Re-Clearance Clinical Health Form

Preceptor Information Request Form

Student Information Request Form 

All clinical clearance documentation requirements are due 14 days prior to the start of the clinical course. If a student is not cleared 7 days prior to the start of the first day of their clinical course, they will be administratively dropped without warning(NO EXCEPTIONS).

REQUIREMENTS PRIOR TO CLINICAL COURSES - All students need to have completed:

1. Submission/approval of Student & Preceptor Information Request Forms
2. Completion of signed Confirmation of Clinical Placement Form - Signed & returned by preceptor
3. Completed contract if required by agency. Signed by facility & university
4. Health clearance through EXXAT - Student needs to be cleared by EXXAT with submission of COVID vaccine/religious exemption*
5. Completed Urine Drug Screen - Result of "Pass" through Castle Branch
6. Completed Background Check - Result of "Pass" through Castle Branch

*Religious exemption of COVID 19 vaccine needs to be approved by practicum site prior to start of clinical hours

School Nurse Practicum Forms:

School Nurse Clinical Experience

Resume for Clinical Work

Practicum Checklist

CLINICAL CLEARANCE DUE DATES

SUMMER 2023 SEMESTER
EXXAT, urine drug screen, and criminal background check Due May 8, 2023
FALL 2023 SPRING 2023
EXXAT Clearance August  January 3, 2022
Urine Drug Screening and Criminal Background Check August  January 3, 2022
Influenza vaccination October 3, 2023 January 3, 2022