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."
Medical Requirements Checklist
Hepatitis B Form
TB Testing Form
Badge Order Form
Flu Vaccination Form
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.
*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 ACEMAPP.
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)
For established students: After completion of the course, upload a copy of each bloodborne module certificate to ACEMAPP.
For new/incoming students: These modules will be available to you beginning the week before orientation. Print or save a digital copy for your records (you will need to upload your certificates to ACEMAPP after orientation).course access
User ID: 9-digit student ID#, including zeros (example: 000112345)
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).
For problems about logging in to self-study modules:
Contact Lisa Longeiret firstname.lastname@example.org