To ensure safe patient care and ongoing regulatory readiness, it is important that all students meet specific requirements based on Penn Medicine policies and procedures. Students must meet all compliance requirements before they are cleared to come on site at each hospital. We request that you send validation that each student in the program meets each of these requirements.
The Health Screening and Regulatory Requirements form must be received by the respective entity representative listed below prior to the start of the clinical rotation.
Please complete the forms below for each group of students you are placing. Fax, or scan and email, forms to the institution representative for which you are requesting.
- Hospital of the University of Pennsylvania
Cynthia Richardson, MSN, RN
- Pennsylvania Hospital
David O'Brien, MSN, RN
- Penn Presbyterian Medical Center
Barbara Anderson, MSN, RN
- Good Shepherd Penn Partners
William Kupchunas, RN,CRRN
- Penn Care at Home & Hospice
Christine Bossone, MSN, RN