Clinical Requirements

Listed below are the various forms required for clinical placements. All forms are in PDF format unless otherwise indicated. To save the form, right click on the link and choose "Save As" or "Save Link As."

Universal Requirements

Medical Requirements Guide – a list of required documentation for nursing students:

Physical Form 

Hep B & PPD Form

  • Use this form if you only need HEP B and/or PPD

Nursing Student Badge Order Form

  • Information about how to order a nursing badge online

Flu Vaccination Form

  • Document proof of seasonal flu vaccination, proof of administration is required
  • Immunitrax website

 

  • Certified American Heart Association Health Care Provider Course Instructors

    The following recommended* contacts are approved for instructing the American Heart Association BLS for Healthcare Provider (CPR and AED) Program.

    Collin Sanders (Executive CPR)
    northgacpr@gmail.com 
    info@executivecpr.com
    www.executivecpr.com 
    770-565-2848 
    Use your KSU e-mail for a discount if calling, or code BLS4KSU if booking your class online

    Dereck Johnston (Cobb County ONLY)
    info@safetyhs.com 
    404-380-1510

    Jeanne Day
    dayscpr@gmail.com 
    404-312-5252

    Romonica Long
    c.h.w.h.74@gmail.com 
    678-306-6190

    Rose Schamback
    schwadeton@yahoo.com 
    404-680-2099

    Trisha Braxton
    braxtoncpr@gmail.com 
    770-334-1268

    *This is not a mandatory list

    CPR cards obtained at the Owls Nest or through the Center of Health
    Promotion and Wellness do not meet the requirements for Nursing Students

    Front and Back copy of your CPR card is due by documentation deadline for submission to Immunitrax

Required Self-Study Modules (Bloodborne)

Must submit three certificates for credit:

  • VIDM273A-T Preventing Bloodborne Infections: Bloodborne Viruses (w/Video) (0.5 hr)
  • VIDM273C-T Preventing Bloodborne Infections: Engineering Controls and Workplace Practice Controls (w/Video) (0.5 hr)
  • VIDM273B-T Preventing Bloodborne Infections: Preventing Transmission, Protecting Yourself (w/Video) (0.5 hr)
course access

User ID: 9-digit student ID#, including zeros (example: 000112345)
Password: nursing

System Requirements

After logging in with the above, click on the "Kennesaw" link, and then choose the module from above that you want to view. From the resultant window that opens, choose the "RealOne" Media Player option (the Windows Media is currently nonfunctional).

After completion of the course, print the certificates and submit them to Jeannette Clarke by email (jclar276@kennesaw.edu) or by fax 470-578-9069, or bring them to her in Room 3004, Prillaman Hall.

For problems about logging in to self-study modules:

Contact Lisa Longeiret (llongeir@kennesaw.edu)

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