Clinical Student Onboarding Checklist
Complete this checklist to ensure all requirements are met before starting your clinical placement.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Educational Institution
*
Program of Study
*
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Immunization Record Upload (PDF, JPG, PNG)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Background Check Confirmation
*
Completed and attached
Pending
Upload Required Certifications (e.g., CPR, First Aid)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Have you completed the clinical orientation session?
*
Yes
No
Signature
*
Submit Checklist
Submit Checklist
Should be Empty: