Piedmont Atlanta / Piedmont Mountainside Hospital

Student Information


  Go to www.piedmont.org/studentorientation Complete online application:

  1. Read #4 Orientation Materials
  2. Read and Complete #5 Student Participation Agreement
    • School Name: Kennesaw State University  Piedmont Facility: Enter Location Assigned
    • Don’t Complete Faculty Information
    • Student Name: Print your name  Signature: Your Signature  Date: Todays Date
  3. Complete one of the following application #6
    • New Student: Applying for their first rotation within Piedmont Healthcare
    • Returning Student: Student was cleared and has completed at least one rotation at Piedmont Healthcare location
    • Employee: Student is a current Piedmont Healthcare employee





    Completing The Application


    Complete all fields of the application


    • Enter your personal information
    • School Name: Kennesaw State University
    • Rotation Start & End Date: Receive information from Laura Allen E-mail
    • School Representative First Name: Lillian
    • School Representative Last Name: Valdez
    • School Representative Phone Number: 470-578-2890
    • School Representative E-mail Address: lvaldez2@kennesaw.edu
    • Piedmont Entity: Select Assigned Hospital
    • Select Floor: Other (bottom) If other: Med Surg
    • Number of clinical hours: 3209 (36 hrs) 3313 (96 hrs) 4417 (172 hrs)
    • Piedmont Coordinator Information:



    Coordinator: Marci Hanson
    Name: Marci Hanson
    Preceptor: Marci Hanson 
    E-mail: Nursing.development@piedmont.org

    Coordinator: Marci Hanson
    Name: Marci Hanson
    Preceptor: Marci Hanson 
    E-mail: Nursing.development@piedmont.org



    • Student will be supervised by: Piedmont Employee
    • AHA BLS Certification Expiration Date : Do not select N/A Enter Renewal Date from Current CPR Card
    • Personal Health Insurance: Yes
    • Professional Liability: COI Provided by School
    • Online Orientation Material Reviewed: Yes (see #1 above)
    • Complete all of the immunization information from your current physical


  5. Must have flu vaccine for fall and spring for current flu season. 
    • Take your flu documentation with you the first day of clinical rotation and your preceptor will take you to employee health to receive a flu vaccine sticker to wear during your clinical.
  6. Log into your Advantage account and select Piedmont to view your drug and background results
  7. Submit a front and back copy of your CPR card (Mountainside ONLY)
  8. Parking at Piedmont Atlanta parking is offered at 1 Collier Road.  Enter the parking area from Collier Road (red arrow at left).  Enter 1938* at the entry gate key pad and park in the lot.  Enter the hospital via the Outpatient Diagnostic Center Entrance, the McDonnell Surgical Center Entrance, or the Main Entrance off Peachtree Road.
  9. Submit a copy of the application and Student Participation Agreement to Lillian Valdez


Document Checklist:

Application (Submit online REMINDER: Before submitting application print a copy and submit to room HS 3004)

Student Participation Agreement (Submit to Room HS 3004)

Flu documentation

Front and back copy of CPR Card (Mountain Side Only)