Nurse Practitioner, Physician Assistant and Nurse Anesthetist Student Process

Advance Practitioner Placement Process

There are five (5) steps listed below. All steps reference documents that must be returned to your Program Clinical Coordinator at least four 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. Please be certain to complete all fields, include an actual signature and then return the form to your School Program Director for their signature.

2. Criminal History Clearances

• FBI Clearance Handout: Please follow the process detailed in the handout and complete FBI Fingerprinting through the Department of Human Services.

• PA State Criminal History Check

• Child Abuse Clearance (it can take up to 30 days to receive the clearance)

• Universal Child Protective Services Law Affirmation Form

• Students assigned to Warren Campus are to complete all three PA State clearances and this additional requirement as outlined by the State of New Jersey.
  • NJ State Police Name Check  

Please print and submit all originals to your Program Clinical Coordinator.

3. Hospital Policies and Acknowledgement Forms

• a. Hospital Policies/Procedures - Please review these two educational readings outlining St. Luke's University Health Network policies and procedures.

       I. Student Orientation

       II. Essentials Newsletter

• b. Acknowledgement forms – These forms attest your willingness to follow hospital policies and procedures.

       I. Privacy, Responsibility and Research Acknowledgments

       II. Student Statement of Responsibility and Research Acknowledgement

       III. IT Agreement - For those students needing IT Access 

Please print all above forms and submit to your Program Clinical Coordinator.

4. Health History Screening. Please ensure your health meets the prerequisites outlined for our two step Immunization History and Drug Screening Requirements.

• a. Immunization History Form - Please review all health history requirements. Students are responsible for costs associated with additional immunizations or testing.

• All students are require to be FULLY vaccinated against COVID-19 and annual flu. Exemptions may be requested.
  • Exemptions (religious or medical) may be submitted to your school program director and then will be reviewed by St. Luke’s personnel. Your school program director will notified you if the exemption is approved.
  • For those with questions regarding new flu requirement, please review this FAQ developed by our Employee Health Department with the exemptions placement..

• b. Drug Screen Requirement - Please review all health history requirements. Students are responsible for costs associated with additional immunizations or testing.

• Your Program Clinical Coordinator can provide you with the names of approved facilities to have the drug screening completed.
  • If the program requires a drug screen prior to beginning the clinical year and there has been no interruption in clinical training and the student is in good standing with the program, that previous drug screen will satisfy the requirements.
• 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 610-739-9332 for further information or to set up an account.

5. Return all fully completed materials to your Program Clinical Coordinator.

Incomplete materials will not be accepted, which will delay your start date.

Additional links and policies:

• Infection Control
• Dress Code 
• Health & Fitness Center 
• Blood Exposure Policy 
• Smoking, Drug and Alcohol Policy 
• Campus Map