Munson Health
 
Students - Forms Required for Clinical Rotation

The following documents are required to be completed before the start of your clinical rotation:

 

Mandatory Safety Education 

 

HIPAA Privacy and Security Course: Initial

To be completed by new students instructions.
  1. Click here to view  HIPAA course
  2. After viewing course you must complete the test
  3. Click here to open the test
  4. Print the test
  5. Complete test and give to your college instructor/ representative

 

HIPAA Privacy and Security Course: Annual

For students who have completed the initial course and have returned for a second or third year
  1. Click here to open the pre-assessment test
  2. Print  the test
  3. Complete the test and give to college instructor/representative
  4. Note:  If you did not pass the test, you must repeat the initial course.  See above for instructions


 

Confidentiality & Systems Usage Agreement

Instructions:
    1. Click here to open the form
    2. Print the form
    3. Read and sign the form
    4. Give the signed form to your college instructor/representative
    5. Exceptions:
      • Respiratory Therapy, Radiology and Pharmacy students will give the signed form to MMC Human Resources on the first day on site
      • For individual nursing student experiences, the student will give the signed form to MMC Human Resources on the first day on site 

 

Parking Registration

Please note that NMC Nursing Students are not required to complete this form.

Instructions:

    1. Click here to open the form
    2. Print the form
    3. Complete the form and give it to your college instructor/representative
      • Respiratory Therapy, Radiology and Pharmacy students will give the completed form to MMC Human Resources on the first day on site
      • For individual nursing student experiences, the student will give the completed form to MMC Human Resources on the first day on site
      • TBA Career Tech Center Students do not need to complete the Parking Registration Form
    4. Students must park in Lot K (including MHC employees working at MMC in a student capacity)
    5. Click here to print Parking Lot Map

 

 

Computer System Access Request Form (Student Nurses ONLY)

Instructions:
    1. Click here to open the form
    2. Complete the form electronically to minimize potential errors that can occur with hand writing.
    3. Print the form
    4. Sign the form
    5. Give the completed form to your college instructor/representative