School of Nursing Facility Specific Requirements Check-Off Sheet For: _______Centennial Medical Center- Parthenon Pavilion_________ Print this sheet, sign & date, and return with your documents. Important Note: Important Note: Scan and e-mail/upload your completed documents, per your faculty’s request (i.e. hard copy, e-mail, dropbox). Keep all of your originals until the end of the semester. ____ TCPS General Orientation Completed ____ TCPS Site Specific Orientation Competed ____ Badge Form Completed ____ Complio Account Current/Compliant ____ View and understand Parthenon Pavilion Presentation ____ Read and understand the Nursing Student Welcome Letter ____ Read and understand the Parthenon Expectations ____ Read and understand Maintaining Professional Boundaries ____ Download, read and sign Protocol for Visitors (submit to instructor) ____ Download the Student Nurse Evaluation Form (fill out after clinical is completed) Please Note: Meditech training is NOT needed for this placement I have reviewed all instructions and materials, as well as verified and completed all requirements listed above, that are required by the facility I will be attending. Name (print): ____________________________________ Signature: _______________________________________ Date Submitted: ____________________________
School of Nursing Facility Specific Requirements Check-Off Sheet For: _______Centennial Medical Center- Parthenon Pavilion_________ Print this sheet, sign & date, and return with your documents. Important Note: Important Note: Scan and e-mail/upload your completed documents, per your faculty’s request (i.e. hard copy, e-mail, dropbox). Keep all of your originals until the end of the semester. ____ TCPS General Orientation Completed ____ TCPS Site Specific Orientation Competed ____ Badge Form Completed ____ Complio Account Current/Compliant ____ View and understand Parthenon Pavilion Presentation ____ Read and understand the Nursing Student Welcome Letter ____ Read and understand the Parthenon Expectations ____ Read and understand Maintaining Professional Boundaries ____ Download, read and sign Protocol for Visitors (submit to instructor) ____ Download the Student Nurse Evaluation Form (fill out after clinical is completed) Please Note: Meditech training is NOT needed for this placement I have reviewed all instructions and materials, as well as verified and completed all requirements listed above, that are required by the facility I will be attending. Name (print): ____________________________________ Signature: _______________________________________ Date Submitted: ____________________________