Educational Experience Checklist for Clinical Students and On-Site Faculty

Print this attachment and complete the items prior to the first experience at EIRMC. Your instructor must sign the form in the appropriate place.

Instructions for Student Background Check

Your school may be able to provide a signed attestation form (Exhibit C) if you have already completed a recent (less than one year) background check. Contact your school for details.

Background checks are required on incoming students to insure the safety of the patients treated by students in the clinical education program. You will be required to order your background check in sufficient time for it to be reviewed by the program coordinator or associated hospital prior to starting your clinical rotation. A background check typically takes 3-5 normal business days to complete. The background checks are conducted by PreCheck, Inc., a firm specializing in background checks for healthcare workers. Your order must be placed online through StudentCheck.

Go to www.mystudentcheck.com and select your School and Program from the drop down menus for School and Program. It is important that you select your school worded as Eastern Idaho Regional Medical Center - Students

Please open the attachment for instructions and Frequently Asked Questions.

If you need further assistance, please contact PreCheck at StudentCheck@PreCheck.com.

Student/Faculty On-Site Health Questionnaire

Print this form, fill out the demographic information and sign the form. You must provide the appropriate documentation of the specific health items requested along with the form.

Confidentiality and Security Agreement

Print this form. Sign the form and print your name in the appropriate boxes. The “Facility Name” is EIRMC and the “Business Entity Name” is the school you are affiliated with.

Student Orientation Booklet

Open the link and read through this important information. This booklet contains practice guidelines to help guide you through your clinical experience. It is our expectation that you are familiar with the contents of this booklet prior to joining us at the hospital.

Parking Acknowledgement Form

Open the link, and print the form. Carefully review the information included in the EIRMC Parking Policy. Sign and date the form.

Safety and Compliance Exam

The Safety and Compliance training includes many regulatory competencies such as fire safety, disaster planning, electrical and oxygen safety, HIPAA compliance, back safety and infection control. You will need to print the certificate generated at the end of the course to receive credit.If you don’t have access to a printer, an electronic photo of the certificate can also be used to provide proof of completion.

Nova StatStrip Information

Review the information in this video to prepare you to properly use the Nova Stat Blood Glucose Meter. There are 26 modules; you must watch the entire 24 minutes to pass.

Nova StatStrip Competency Form

Meditech Orientation Online Tutorial

This page contains Meditech student orientation tutorials. Please note that you need Adobe Flash Player to see the content. There are instructions on downloading this for free, once you click on this hyperlink.

Exhibit A, Statement of Responsibility

Print this form, enter the name of your school in the first blank, sign and date. If you are under the age of 18, your parent or legal guardian must sign and date this form.