Clinical Agency Mandates
Information for Compliance with Health and Agency Mandates
Affiliated agencies require students to comply with all health and training requirements of any clinical placement agency. We have listed many resources here for your convenience.
It is a policy of the ATRN, EXER, and CEP Programs that ALL students who have a clinical/agency placement MUST complete A Criminal Background Check and Drug Testing.
- Bloodborne Pathogen Tutorial and Test
- Criminal Background Check Information
- Drug Screen and CBC Agreement Form
- Drug Testing Sites
It is a policy of the ATRN, EXER, and CEP Programs that all students who have a clinical/agency placement MUST carry liability insurance. These three companies offer Liability Insurance to students.
- NSO – www.nso.com or call 1-800-247-1500
- HPSO – www.hpso.com or call 1-800-982-9491
- MARSH – www.proliability.com or call 1-800-621-3008
Students assigned to the following agencies must complete cited Orientation Packets. Completed Orientation Packets must be submitted to the clinical coordinator of each program.
Carolinas Medical Center Northeast
Undergraduate Students
- Student Module Part I
- Student Module Part II
- CMC NE Education Affiliation Information
- HIPAA Privacy & Security Laws
- Temporary Staff, Students, and Volunteers
- Corporate Compliance
Graduate Students
- Student Registration Form
- HIPAA Privacy Training Manual
- HIPAA Post-Training Test
- Acknowledgement of Training Statement
- Assurance of Confidentiality
- Release and Assurance Form
- HIPAA Privacy & Security Laws
- Temporary Staff, Students, and Volunteers
- Corporate Compliance
Novant Health (Forsyth, Presbyterian, Rowan Regional)
- H1N1 Vaccine Information
- H1N1 Vaccine Consent/Decline Form
- Tobacco-free Acknowledgement
- Hepatitis B Declination Form
- Resident-Student Information Form
- Clinical Education Agreement (Exhibit D Only)
- Tobacco-free Acknowledgement
- Confidentiality Agreement
- Hepatitis B Declination Form
- Resident-Student Information Form
- Clinical Education Agreement
- Student Checklist
- Student RRMC Form
- Tobacco Free Acknowledgement
CaroMont-Gaston Memorial Hosptial
Salisbury VAMC
- VAMC Map
- MTT Instructions
- Computer Access Information
- Name Badge Form
- Finger Print Registration
- Student Evaluation Form
- Faculty Evaluation of Clinical Experiences
- Learner Preceptor Survey
- Student Clearance