Clinical Passport Facility-Specific Requirements

Medical staff scanning

Clinical Passport Facility-Specific Requirements

For clinicals at the following facilities, complete the additional orientation requirements before your clinical start date. Follow the web link to your assigned facility for more information.

Henry Predolin School of Nursing Edgewood College Students

Students should check the clinical course Black Board site for first day instructions.

Agrace Hospice

Student Orientation Packet (PDF 3MB)

Confidentiality Agreement (PDF 402KB)

Center for Healthcare Education and Simulation (CHES)

Student Orientation Packet (PDF 101KB)

St. Mary’s Hospital

Student Orientation Packet (PDF 176KB)

Confidentiality Agreement (PDF 55KB)

Confidentiality Agreement for Access to the Clinical Data Repository (PDF 86KB)

Unity Point Health – Meriter Health Services

Student Orientation Packet (PDF 1MB)

Confidentiality Policy (PDF 51KB)

Information Security Agreement (PDF 238KB)

Madison College Students

Agrace Hospice

Student Orientation Packet (PDF 3MB)

Confidentiality Agreement (PDF 402KB)

Reedsburg Area Medical Center

Student Orientation Packet (PDF 369KB)

Reedsburg Area Senior Life Center

Student Orientation Packet (PDF 328KB)

Caregiver Misconduct-Abuse, Neglect, Misappropriation of Property and Injury of Unknown Origin Protocol (PDF 1.4MB)

Sauk Prairie Healthcare

Student Orientation Packet (PDF 305 KB)

Student Information Form (DOC 246KB)

SSM Health – St. Clare Hospital

Student Orientation Packet (PDF 2.6MB)

Confidentiality Agreement (PDF 70KB)

Confidentiality Agreement for Access to the Clinical Data Repository (PDF 86KB)

St. Mary’s Hospital

Student Orientation Packet (PDF 176KB)

Confidentiality Agreement (PDF 55KB)

Confidentiality Agreement for Access to the Clinical Data Repository (PDF 86KB)

Unity Point Health – Meriter Health Services

Student Orientation Packet (PDF 1MB)

Confidentiality Policy (PDF 51KB)

Information Security Agreement (PDF 238KB)

Moraine Park Technical College Students

Beaver Dam Community Hospital 

Student Orientation Packet (PDF 161KB)

Southwest Technical College Students

Bloomfield Healthcare and Rehab (html)

Boscobel Area Health Care and Boscobel Care and Rehab (html)

Fennimore Good Samaritan Society (html)

Grant Regional Health Center (html)
*Grant Regional Health Center highly recommends students receive the Influenza vaccine but it is not mandatory (updated: 11/15/2013)

Memorial Hospital of Lafayette County (html)

Orchard Manor (html)

Pine Valley HealthCare and Rehab Center (html)

Prairie du Chien Memorial Hospital (html)

Prairie Maison (html)

Richland Hospital (html)

Southwest Health Center (html)

Upland Hills Nursing and Rehab and Upland Hills Health (html)

«Return to previous page