Patient Safe Handling Acknowledgement

Code of Conduct Acknowledgement

HIPAA Training Materials for Students

Student Acknowledgement Form

Student Clearance Release Form

Student Confidentiality Agreement

Student Supervision Agreement

☐ Background check (within one year with all required criminal checks below – no exceptions!)

• Federal Criminal
• Nationwide/National/Multi-State Criminal
• State Criminal
• County Criminal
• SSN Verification/SSN Trace
• National Sex Offender Search
• OIG/HHS Search
• SAM/GSA Search

☐ State background required in CO, DE, FL, ID, IA, IL, IN, MA, MN, MO, OK, PA, SC, UT, VT, VA, & WI

☐ State background conducted by the facility in NV, NM, OR, RI (NV fingerprints are run onsite day one)

☐ CPR Certification (required in AZ*, IN*, MD*, MO*, NM*, NV, SC*, TX*, WI*)

☐ Drug Screen (ten-panel required in CA, CO*, DE, KS*, LA*, NV, & TX*)

☐ Fingerprints (required in AZ, DE, FL, IL, KS*, KY*, MN, MD, NC*, NV, & OK)

☐ Fire Safety Card (required in City of Los Angeles, CA)

☐ Flu shot (required in CA* & CO)

☐ Hepatitis B (proof or waiver required in NV & SC)

☐ MMR (proof or waiver required in MD & RI)

☐ Physical (required in CA, HI, IN, KS*, & NV)