Clinical Track Forms

Clinical Courses & Preceptor Information

Tips for finding a preceptor

Exxat Instructions

Typhon Instructions

Frequently Asked Questions

COVID:  Assumption of Risk Form

Clinical Site Evaluation Form

Clinical Evaluation of Preceptor by Student

Drug Screening and Testing

Grad Nursing Clinical Checklist- EXXAT

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 "APPROVED" through Universal
6. Completed Background Check - Result of "APPROVED" through Universal

*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