St. Luke's University Health Network

Physician Assistant Clinical Students

Physician Assistant Student Process

There are nine (9) steps listed below. Several steps reference documents that must be returned to your Program Clinical Coordinator at least two weeks prior to your intended rotation start date. Incomplete materials will not be accepted which may result in a delayed start date.

Steps To Be Completed

1. Registration Form 
  • Complete the entire form, ensuring a start and end date and the name of the St. Luke's Hosting Supervisor are listed. Please print and return the registration form to your Program Clinical Coordinator.
2.

a.  FBI Fingerprinting

b. Universal Child Protective Services Law Affirmation Form

  • Please print and return to your Program Clinical Coordinator.
3.

a. Commitment to Privacy

  • Please print and return to your Program Clinical Coordinator.

b. Student Statement of Responsibility

  • Please print and return to your Program Clinical Coordinator.

c. Agreement of IT Access

  • Please print and return to your Program Clinical Coordinator.

d. Physician Assistant Student IT Access

  • Please print and return to your Program Clinical Coordinator.

e. Student Volunteer Instructor Research Consent and Release Form (updated 5/22/2014)

  • Please print and return to your Program Clinical Coordinator.
4.

a.  Immunization History Form (updated 05/22/2014)

  • Please ensure your health history meets the requirements outlined in the Immunization History form. Students are responsible for paying for additional immunizations or testing.
  • It is important to note that all students are to have the most current, annual flu shot during flu season. Exemptions (religious or medical) may be submitted to your school program director and will be reviewed by St. Luke’s personnel for review. Your school program director will be notified if the exemption is approved.
  • For those with questions regarding new flu requirement, please review this FAQ developed by our Employee Health Department.

b. Drug Screen Requirements Form

  • Your Program Clinical Coordinator can provide you with the names of approved facilities to have the drug screening completed.
5. Standards of Performance Booklet
  • Please read this booklet as it contains the guiding principles of St. Luke's University Health Network which student interns are expected to uphold.
6. Essentials Newsletter 
  • Please read the newsletter; it explains important safety practices and policies every student must be aware of during your internship at St. Luke's University Health Network.
7.

Orientation - Review the following pages.

Print and sign the Orientation Completion Acknowledgement document.

8.

Return all fully completed materials to your Program Clinical Coordinator. Incomplete materials will not be accepted, which will delay your start date.

9.

Students assigned to Warren Campus are to complete these additional requirements.

In addition to meeting the Network requirements, the State of New Jersey has additional requirements which include:

  • NJ Department of Treasury (SDN)
  • NJ Consolidated Debarment Report
  • Those students with a significant likelihood of contact with children must also complete New Jersey State Police Criminal History Check. The required form is provided to the student by the Warren Campus hosting manager. To complete the form in the proper format, follow the instructions in the attachment.

Printed copies are to be provided to your school program director.


If you have any questions about the orientation content or process, please call your Program Clinical Coordinator.