The Clinical coordinator at the school must complete a student clinical request form and email it to [email protected] four weeks prior to the requested dates of clinical. Please indicate on the form whether the student will need computer access.

Any student clinical request received less than four weeks prior to the start date will result in a delay.

Every individual student within the cohort must submit a signed confidentiality and acceptable use requirements form.

For programs that have a cohort of more than six students listed on the student clinical request form CHI St. Vincent will perform an immunization audit. The Clinical Student Manager will email an audit form to the school. The form is expected to be completed and returned to the Clinical Student Manager in 24-48 hours. The date and time will be noted on the email sent to the school. 

Files to download and/or fill out online: