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

Rotations will be cancelled if forms and information are not complete and approved a minimum of two (2) weeks prior to the start of the rotation.

Forms

• Physician Assistant Student Information Form

  • Must be completed for EVERY rotation scheduled at an Advocate Hospital/Medical Center

• Medical and Immunization 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.

  • TB information must be current within one (1) calendar year of the rotation start date. If your TB test expires during your rotation you are required to get an updated test prior to the rotation start date. If you're current TB test was positive, proof of a negative chest x-ray or medical clearance is required. If you had a positive TB test in the past, a screening questionnaire completed within one year of your schedule rotation is sufficient for clearance.

  • 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.

  • The student is required to sign the form to verify the accuracy of the information.

• Access Form

  • Care Connection/Confidentiality Form

Required Information

• Evidence of completed Criminal Background check-- supplied by the university/PA Program to Site Coordinator

• Evidence/verification of OSHA/Universal Precautions Training--supplied by the university/PA Program to the Site Coordinator

• Evidence/verification of HIPAA training--supplied by the university/PA Program to the Site Coordinator

• Copy of BLS and or ACLS certification (as applicable)