SMU transmits the summary results of the background to the clinical agencies in advance of a student beginning a clinical experience. Those summary results indicate only whether or not there were findings on the background check, not the specifics of the findings. The full results are released to the clinical agency only with the student’s consent and only when requested by the clinical agency. A clinical agency may refuse to accept a student on a clinical experience based on the background check results. Student Consent to Release of Criminal Background Information Samuel Merritt University requires students to participate in clinical experiences at health care providers as part of its curriculum. Nearly all clinical agencies require that students at Samuel Merritt University complete a background prior to accepting students at the agency. By signing below you are giving your consent for Samuel Merritt University to release your criminal background results to health care agencies where you are assigned to have a clinical experience upon the clinical agency’s request. I CONSENT TO THE RELEASE OF MY BACKGROUND CHECK RESULTS TO CLINICAL AGENCIES TO WHICH I AM ASSIGNED IN ORDER TO FACILITATE MY PLACEMENT AT THAT LOCATION. I UNDERSTAND THAT: This consent will remain effective until I rescind it in writing. I understand that I am voluntarily giving this consent and that it is not required by law or University policy to give this consent. I understand that if there are convictions contained in my criminal background I may not be placed into a clinical experience and without the completion of clinical experiences, I cannot complete my educational coursework and graduate. Student ID#: ___________________________ Name: __________________________________ Student Signature: ___________________________ Date_________________ 12. POLICY APPENDICES
SMU transmits the summary results of the background to the clinical agencies in advance of a student beginning a clinical experience. Those summary results indicate only whether or not there were findings on the background check, not the specifics of the findings. The full results are released to the clinical agency only with the student’s consent and only when requested by the clinical agency. A clinical agency may refuse to accept a student on a clinical experience based on the background check results. Student Consent to Release of Criminal Background Information Samuel Merritt University requires students to participate in clinical experiences at health care providers as part of its curriculum. Nearly all clinical agencies require that students at Samuel Merritt University complete a background prior to accepting students at the agency. By signing below you are giving your consent for Samuel Merritt University to release your criminal background results to health care agencies where you are assigned to have a clinical experience upon the clinical agency’s request. I CONSENT TO THE RELEASE OF MY BACKGROUND CHECK RESULTS TO CLINICAL AGENCIES TO WHICH I AM ASSIGNED IN ORDER TO FACILITATE MY PLACEMENT AT THAT LOCATION. I UNDERSTAND THAT: This consent will remain effective until I rescind it in writing. I understand that I am voluntarily giving this consent and that it is not required by law or University policy to give this consent. I understand that if there are convictions contained in my criminal background I may not be placed into a clinical experience and without the completion of clinical experiences, I cannot complete my educational coursework and graduate. Student ID#: ___________________________ Name: __________________________________ Student Signature: ___________________________ Date_________________ 12. POLICY APPENDICES