Advocate Medical Group Medical Student Office
701 Lee Street, 1^st Floor
Des Plaines, Illinois 60016
Advocate Medical Group Medical Student Handbook

Required Forms:

Once a rotation is scheduled or approved, the following forms and information must be received by the Medical Student Office a minimum of two (2) weeks prior to the rotation start date. Information can be submitted via e-mail, fax, or postal service. Students must follow-up with the Coordinator to ensure paperwork has been received.

All Students/Rotations:

• Medical Student Information Form
  • Must be completed for EVERY rotation scheduled at an Advocate Medical Group practice site
• Medical and Immunization Clearance Form (Health Form)
  • • TB Test - If TB test expires during a scheduled rotation, an updated test is required prior to the rotation start date. Positive TB test (9+) requires proof of negative chest x-ray (must be dated after positive TB test) and TB Questionnaire (valid for 1 calendar year).
    • TB Questionnaire (as applicable)
  • Mask Fit Test - Every student, rotating on a clinical service, must be fit tested for a TB mask. The date and type of mask must be indicated on the medical clearance form.
  • Vaccination/Immunity Status - Student must indicate the date of the immunity titer and circle the result. If no titer, please indicate vaccination dates as listed.
  • Flu Vaccine - Students are required to be vaccinated within one (1) calendar year of the rotation start date.
  • Students are required to sign the form to verify the accuracy of the information.
• Confidentiality Agreement
• Care Connection Form

Students from schools other than UIC, RFUMS, and Midwestern-CCOM:

• Letter of Good Standing - The letter must be on University/Medical School stationery and be signed by the Office of Student Affairs. Must verify student academic status, the medical school's approval/authorization of the named elective, and the student evaluation requirements. Also must include verification or documentation of the following:
  • Evidence of completed Criminal Background check-supplied by the university/medical school to Medical Student Office
  • Evidence/verification of OSHA/Universal Precautions Training-supplied by the university/medical school to the Medical Student Office
  • Evidence/verification of HIPAA training-supplied by the university/medical school to the Medical Student Office
  • Verification of student health insurance coverage
• Documentation of malpractice/liability insurance in the required amounts of $1 million per occurrence/$3 million aggregate

Parking Information:

Arlington Heights

Bourbonnais

Buffalo Grove

Hyde Park

Olympia Fields

Orland Park

Wauconda

Directions to the Medical Student Office:

1. Park in Lee Street parking garage on first level.
2. Enter building through revolving doors in parking garage.
3. The entrance to the Medical Student office will be the first door on the left, before you reach the elevators. (Suite 110)
4. Ring the bell and someone will let you in.