BLS Expiration Date: Expiration Date off your CPR card
Last TB/PPD Assessment Date: Last ppd date within 90 days
Hepatitis B Vaccine: 1st Hepatitis date on your physical or titer date
Information Security Agreement Signed (2nd Page): Date you signed the Confidentiality and Security agreement
Fall semester flu documentation must be submitted by 1st of October – Spring semester flu documentation must be submitted with clinical paperwork
E-mail your drug and background screening from Advantage to Lori Smola @ Lori.Smola2@hcahealthcare.com - in the e-mail subject line type: KSU Drug & Background Screening
Before you can start clinical it’s mandatory that you:
§ Pick up your badge from Lori Smola at Cartersville Medical Center HR Department on the 1st floor. HR Department Hours: Monday- Friday 8am-4pm
§ 15 days before first day of clinical E-mail Robbie Tatum (Robbie.Tatum@HCAHealthcare.com) to confirm Badge administration days. In the e-mail subject line: KSU Badge Request
4417 Preceptorship ONLY
In addition to completing steps 1-6 above, you must schedule a time with Robbie Tatum (Robbie.Tatum@HCAHealthcare.com) 15 days before your first day of clinical to watch the Code of Conduct Video (1hr video). In the e-mail subject line: KSU Code of Conduct Schedule & Badge
Medical Documents that must be submitted with your clinical paperwork
Front and back copy of your current cpr card
IMMUNIZATIONS
PPD:
Negative PPD: Negative ppd within 90 days
- If your PPD is not within 90 days Cartersville Medical Center requires you to have another test administered. Contact your Personal Health Care Provider or you can have the test done at the KSU Clinic, the cost is $5.00 call 770-423-6644 to schedule an appointment. (The updated PPD must be submitted with your clinical paperwork)
OR
Positive PPD: Chest X-ray or radiology report within the last 12 months AND documentation of taken prophylactic medication
OR
Quantiferon: Must be negative result
Proof of tetanus immunization
Proof of Varicella or titer value report
Proof of two MMR immunization or titer value report
Proof of three Hepatitis B immunization or titer value report
Current Flu documentation
Document Checklist
Behavioral Standards (1 page)
Confidentiality and Security Agreement (2 Pages)
Student Orientation Answer Sheet (1Page)
Attestation Form for Contract/Agency/Student Personnel (2 Pages)