Students requesting a rotation at Deaconess must complete all requirements as outlined below.
Student Application Requirements:
- An Affiliation Agreement must be signed between Deaconess and the College you are attending.
- Student must be enrolled in a technical or college level program performing supervised patient care or operational activities in partial fulfillment of the requirements of a degree or credentialing program. Examples: Students from respiratory therapy, physical therapy, pharmacy, medical assisting, EMT, etc.
- Please provide the following vaccine information:
Student Request Process:
- MMR documentation (2 doses or immune titers for Rubella/Rubeola (measles/Mumps)
- Varicella (chicken pox) documentation (2 doses of vaccine or immune titer)
- T-spot TB test given in the last 12 months. Two TB skin tests given in the last 12 months are required for Surgery or Emergency Department. One QuantiFERON TB Gold blood test is acceptable to meet this requirement.
- COVID Vaccine documentation
- Influenza (flu) documentation for current season (October 1-March 31)
- Hepatitis B series vaccination or a signed declination
2021 Orientation Packet
- Print out and complete the required paperwork, scan forms and immunization documents to firstname.lastname@example.org.
- All required documents should be completed along with documentation of immunizations and returned to HR no later than 2 weeks prior to start date of rotation
- Advisor of college program should work with their program contact person at Deaconess for details of student requirements, dates, etc.
- After supporting documents, and rotation availability have been reviewed, you will be contacted with an approval or denial via email or through your school advisor.
DHS Non-Employee Statement of Conflict
Regulatory Agency Requirement Form