Please Note: Registration for student programs should be received at least two weeks in advance of the requested start date.
- Criminal history record check
- The Dean or Director of the program will ensure that the criminal history record check and fingerprinting are obtained prior to their students beginning a clinical rotation at Memorial, and that the results are on file with the academic institution
- The healthcare academic professional/vocational technical academic program shall provide assurance to Memorial that the results of the student’s criminal history would not prohibit the student from being able to conduct his or her clinical activities at the Hospital
- Current BLS card
- Proof of immunization (MMR, Tdap, Varicella, Hep B)
- Negative TB test (within the last 12 months) or documentation of prior positive and negative TB history questionnaire (provided by Memorial on request)
*The academic institution is required to submit an attestation verifying the above. We do not collect health information on students.
Student Registration (clinical and non-clinical)
All students enrolled in an academic program who wish to complete a rotation at Memorial Hospital must complete the following registration form.
You may also download and submit the Registration Form. Email the completed form (as an attachment) to firstname.lastname@example.org. Forms submitted via URL link to a cloud-based drive will not be processed.
Once you have submitted a completed registration form you will receive an email from Memorial’s Student Coordinator on how to proceed.
Students will be provided with a map of approved parking areas prior to arriving at the Hospital.