- March 29, 2024
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Physical Therapist Assistant Application Period
September 15, 2023 - May 26, 2024
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RN-to-BSN Fall 2024
November 1, 2023 - June 1, 2024
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Occupational Therapy Assistant Application Period
December 1, 2023 - June 1, 2024
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Veterinary Technology Application Period
February 1, 2024 - May 31, 2024
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Health Sciences Clinical Resources
- Affiliation Agreement Request Form
- Out of Service Area Affiliation Data: Word | PDF
- Medical Clearance Form (Return to Clinical)
For Professional Nursing Students Only
Professional Nursing students should follow the instructions on this page to complete the N95 Fit Test and OSHA Respirator Medical Evaluation Questionnaire.
For All Other Health Sciences Programs
For Instructors:
- Enter the student information into the N95 Fit Test Authorization Request Form.
- Send the completed form to [email protected] and cc Christopher Beckermann.
For Students:
- Important: Once the tech has completed the fit test, ask for a copy of your results or take a picture with your smart phone. The results are not sent back to the department. You must obtain a copy and save this document in a safe place. It is an official record.
- Once you have completed the fit test, please confirm your mask brand and size with the staff performing the fit test before you leave the facility (sometimes the information written on the form is difficult to read).
- All students are required to watch this safety video prior to going to any clinical sites. Students who do not complete this requirement will be unable to attend clinical.
- Master Attestation Form
- Attestation Form (Diagnostics and Therapeutics, Pharmacy, and Imaging only)
- Attestation Form and Pre-Placement Requirements (OTA/PTA Rehabilitation Services only)
- Badge and Parking Directions (updated 10/2023)
- Off-Site Parking – Hyde Park Baptist Church (updated 10/2023)
- COMPASS Access Agreement for Faculty
- COMPASS Access Agreement for Students
- COMPASS Training (MyLearning) Form (Faculty only)
- Pre-placement Requirements Modules
- Clinical Rotation Attestation Letter (updated 10/2023)
- Education Affiliation Agreement Checklist
- Allied Health Student Orientation Instructions
- Online Orientation
- Network System User Agreement
- Nursing Student Orientation Acknowledgement of Completion
- HIPAA Training Acknowledgement
- Student Substance Abuse Policy
Every student or instructor already on site must be compliant by November 1, 2023.
Flu Shot Information
- Online Orientation Process
- Completion of CSR Orientation Certificate for Faculty (must review all orientation information below prior to filling out the certificate. Orientation information can be found on the Christus website here.
- Completion of CSR Orientation Certificate for Students (must review all orientation information below prior to filling out the certificate. Orientation information can be found on the Christus website here.
- Notification of Experience – Single Student
- Notification of Experience – Multiple Students
- EPIC Computer Access Request Form
- Computer Agreement/Confidentiality
- Vaccination Verification Ancillary
- Immunization Exemption Form
- Verification Form
Updated: October 2023
- Student Checklist (updated 10/2023)
- Clinical Affiliation Contract Exhibits A-D (updated 10/2023)
- Environment of Care (EOC) & Emergency Response (updated 10/2023)
- Infection Control & Prevention (updated 10/2023)
For Ben White location only:
Hospital Emergency Codes
- Accudose Security Agreement
- Attestation Form (updated March 31, 2023)
- Faculty Orientation Manual (updated March 31, 2023)
- Faculty Orientation Manual Attestation Form
- Student Orientation Manual (updated March 31, 2023)
- Student Orientation Manual Attestation Form
- Mandatory Orientation Module and Post Test
- Statement of Responsibility
- Meditech Access Request Form and Confidentiality & Security Agreement
- ICARE My Commitment to Our Values Form
- Substance Use in the Workplace Acknowledgment (updated Fall 2022)
- OSHA Respirator Medical Evaluation Questionnaire (updated April 6, 2023)
- Fit Test Verification and Attestation Form
- Flu Vaccine Verification and Attestation Form
- USP <800>: Safe Handling of Hazardous Drugs Module and Post Test
- Bridging the Gap Modules (Complete Modules 1-4 only)
- St. David’s Ambulatory Student Packet
- COVID-19 Self-Screening Attestation Form (updated 10/2023)
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Health Sciences Updates
Attention! All students that have not been accepted into an ACC Health Sciences program…
All students who have not been accepted into an ACC Health Sciences program should declare General Studies in Pre-Health Sciences (Associate of Science) for their major. Once accepted into a program, the student's major will be updated.
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