Undergraduate
A current Affiliation Agreement must be on record between your School/University and the University of Pennsylvania Health System in order to request a nursing student clinical rotation. Undergraduate nursing students are required to complete these two steps:
- Complete the Request for Student Placement form and scan/email it to the respective liaison listed below. Note that established and/or long-standing clinical rotations will take precedence over new requests.
- Complete HIPAA form
Requests should be received by no later than six (6) weeks prior to the requested clinical start date(s). Your request(s) will be acknowledged upon receipt and you may expect a response to your proposed request no later than four (4) weeks prior to the start of the clinical rotation.
Graduate
It is the responsibility of the graduate nursing student to identify their clinical preceptor and confirm start and stop dates. Graduate nursing students are required to complete these three steps:
- Complete the Graduate Nursing Student Information Form
- Complete HIPAA form
- Provide copy of Pennsylvania state license
Submit Completed Forms
Please fill out and scan/email all items to the institution representative to whom you are making a request:
- Hospital of the University of Pennsylvania / CPUP
Barbara A. Todd, DNP, ACNP-BC, FAANP, FAAN
Email: HupUGNursing@pennmedicine.upenn.edu
Office: 215-615-1556
Cell: 215-720-9864
- Pennsylvania Hospital
Kirstin Azuma MSN, RN, CBC
Student Placement Coordinator
Email: PAHNsgStudCoord@pennmedicine.upenn.edu
Office: 215-829-7639
- Penn Presbyterian Medical Center
Mary Ann Jones, MSN, RN, CRNP, CNS, CNE
Email: MaryAnn.Jones@pennmedicine.upenn.edu
Office: 215-834-1632
- GSPP Rehabilitation
Chelsea Flick Roderiguez, MSN, RN, PCCN-K
Email: Chelsea.Flick@pennmedicine.upenn.edu
Phone: 215-893-2577
- Penn Care at Home & Hospice
Penn Medicine at Home
Mary Denno, MSN, RN, NE-BC
Director of Practice and Professional Development
Email: Mary.Denno@pennmedicine.upenn.edu
Office: 610-617-2400
Cell: 215-200-7149
- Lancaster General Hospital
Christian Agustin, MSN, RN, CRRN
Email: ChristianDarwin.Agustin@pennmedicine.upenn.edu
Phone: 717-544-4382