St. Luke's University Health Network

PA Clinical Students

Program Clinical Coordinator Rotation Process for Physician Assistant Students

Please read the below information which outlines St. Luke's requirements to process a PA student. The Registration; Commitment to Privacy; IT Access form & Agreement; Student Volunteer Instructor Research Consent and Release form; Non-Employed Disclosure Authorization and Release form; and Record Verification forms are to be returned to the St. Luke's University Hospital - Bethlehem Campus at least two (2) weeks prior to the student's intended start date to Maureen Barrett, MPAS/PAC, Chief PA. Those students who have a criminal history are to also include the Criminal Background Investigation Report form and all original State/Federal issued criminal reports.

Rotation start dates will be delayed if materials are not received at least two weeks prior to the student's intended start date.

Please note that audits will be conducted to verify St. Luke's standards are met. Educational contracts will be revoked if files are incomplete.

Please call Maureen Barrett, MPAS/PAC, Chief Physician Assistant at 484-526-4641 with any questions.

Steps To Be Completed

1.

Guidelines for Processing PA Students (updated 2/13/2014)

  • Please read the attached for an explanation on processing PA students.
  • View our online presentation for School Program Directors.

Students assigned to the Warren Campus will need to meet 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.
2.

Criminal Background Investigation Report

  • If a criminal history is reported on the FBI Fingerprint Report, Child Abuse Clearance or PA State Police Criminal Background Check, please print this form and have the student complete and mail, along with all original criminal history reports, to the St. Luke's University Hospital - Bethlehem Campus.
3.

Immunization History Form  (updated 07/09/2013)

  • This form outlines the St. Luke's health history requirements which are to be kept on file at the school.
4.

Drug Screen Requirements

  • St. Luke's requires a five-panel drug screen on all PA students as explained in the attachment.
  • If the school does not have a method of providing drug screening, drug screen services are available through St. Luke's Occumed Resources located at St. Luke's North. Please contact Donna Corsi at 484-526-3769 for further information or to set up an account.
5a.

Record Verification for Student Interns (updated 03/28/2014)

  • Please print the attachment and return to Maureen Barrett, Chief PA at the St. Luke's University Hospital - Bethlehem Campus along with the Registration and Commitment to Privacy Forms.
5b. Warren Campus Student Verification Form (updated 03/28/2014)
6.

TB Questionnaire

  • Please print the attached form and provide to students who have had a positive TB test in the past. This form, along with a clear chest X-ray and/or BAMT (Blood Assay Mycobacterium Tuberculosis) test, should be kept with the student's medical file.
7.

Hepatitis B Declination Form

  • Having the Hepatitis B series is strongly recommended for students completing an internship at St. Luke's, but is not required. Should a student decline the vaccine, the attached form should be completed and kept on file with their medical history.
8.
  • Please return the Registration, Commitment to Privacy form, Non-Employed Disclosure Authorization and Release form, Record Verification form and Student Volunteer Instructor Research Consent and Release form to:
    Maureen Barrett, Chief PA
    St. Luke's University Hospital - Bethlehem Campus
    801 Ostrum Street
    Bethlehem, PA 18015
  • Postal mail required forms for students assigned to the Warren Campus to:
    Keesha Eato
    St. Luke's Coventry Family Practice
    755 Memorial Parkway, Suite 300
    Phillipsburg, NJ 08865
  • Incomplete materials will not be accepted, which may delay your PA student's start date.