Clinical Site Information for Students

Students are NOT to contact the facilities below. Please note the following:

  • If a clinical document deadline has not been given with your placement, please submit documents within 48 hours to room 3014 or email to nu_medrecords@kennesaw.edu
  • Background checks and drug screens are performed through the WSON preferred vendor at program entry (do not complete until advised to do so) and following a break in attendance; the reports are utilized by most clinical sites to meet the clinical requirements. Additional screenings may be required by the clinical site as assigned. If you have a flagged background check report, please notify nu_medrecords@kennesaw.edu.
  • Student Information

    • No clinical paperwork to complete
  • Student Information

    1. *IF YOU ARE A MALE STUDENT* We are required to report to the VA the status of your registration for selective service. Please email nu_medrecords@kennesaw.edu and declare whether or not you are registered.

    2. Review and complete the Student Cover Page and Checklist and documents listed on the checklist.  Signatures cannot be electronic. Documents not fully completed will not be accepted by the VA.

    3. You must have your Driver’s License, & SSN card on your first day onsite.

    Submit all documents including copies of your medical documents to the submission box for NURS 3314 at the Nursing reception desk.


    List of all documents to meet VA requirements:

    • Student Cover Page and Checklist (3 completed pages)
    • VA Application for Health Professions Trainees (4 pages)
    • Declaration for Federal Employment (2 pages)
    • Appointment Affidavit (does not need to be notarized)
    • Health Professions Trainee Random Drug Testing Notification & Acknowledgement Memo
    • Without Compensation Health Professions Trainee Offer Letter
    • Students must review the Student Nurse Education Module which includes the following Atlanta VAMC polices and complete a set of test questions:
      • Includes:  Administration of medications; patient lifting, restraints & seclusion & Code 99
    • Four Certificates of completion: (4 pages – use the TMS Help Resources – Students User for assistance as listed on your student cover page)
      • 1) Mandatory Training for Trainees
      • 2) Safe Patient Handling & Movement Video
      • 3) Preventive Management of Disruptive Behavior- PMDB Level I
      • 4) Mental Health Environment of Care Checklist Training for Clinical Staff
    • Varicella Guidelines and Waiver or Proof of vaccines or positive titer
    • HepB Vaccine Waiver Statement or Proof of positive titer
    • Covid-19 Vaccination Form & proof of vaccines
    • Negative PPD, QuantiFERON Gold, Tspot or Chest X-ray within 12 months which may not expire during your clinical rotation
    • Flu vaccine (optional)
    • Front and back copy of your CPR card
  • Student Information

    • Student Information - No paperwork.
  • Student Information

    • Print a copy of your full Background Check from Advantage Students and E-mail to Susie Gloth at sgloth@cartersville.k12.ga.us two weeks prior to the first day of clinical. (Please cc nu_medrecords@kennesaw.edu to notify you have completed the requirement.)
    • In the subject line type: KSU Clinical Background Check Report.
  • Student Information

    Since the Cartersville Medical Center is now part of the Piedmont System, see Piedmont Hospital below and follow the instructions.

  • Student Information

    1. Complete Internship Volunteer Paperwork

    2. Please provide the additional documents:

      Copy of background check
      Copy of state ID
      Copy of school ID
    3. After completion of above documents please submit to Room 3014 or e-mail to nu_medrecords@kennesaw.edu

  • Student Information

    When assigned to this location, please email nu_medrecords@kennesaw.edu for a documentation link to complete the required online forms.

  • Student Information

    1. If you have been assigned to CHOA you will receive an e-mail from Symplr providing instructions. Credentialing for CHOA will cost $49
    2. If you do not receive Symplr’s e-mail 1 week after notification of placement please contact Lisa Longeiret and Gregory Williams at nu_medrecords@kennesaw.edu.
    3. Please read Symplr’s instructions carefully, detailed information is listed for required uploads and documentation
    4. Manager should be listed in Symplr as Lisa Longeiret or Gregory Williams at nu_medrecords@kennesaw.edu, 470-578-6061.
    5.  If you receive a denial for any reason on any portion, please notify Lisa Longeiret and Gregory Williams at nu_medrecords@kennesaw.edu.
    6. CHOA does their own background check through Symplr, you can print your drug screen from Advantage Students and upload the results to satisfy the drug test requirement
    7. CHOA encourages you to download the Symplr Mobile App (after connecting to their site you can upload required documents and it will provide you with real time compliance status)
    8. Symplr will show green light status when you have completed each portion of credentialing
    • Parking Information
       
    • CLINICAL INSTRUCTORS

      CLINICAL GROUPS

      PRACTICUM/PRECEPTED STUDENTS

      ADVANCED PRACTICE STUDENTS

      Scottish Rite

      Clinical Instructors/Faculty/Clinical Groups/Practicum Students can park in the main deck. The badge will grant access to parking deck through Employee Entrance/Exit.

      Egleston

      Clinical Instructors/Faculty/Clinical Groups/Practicum Students cannot park in the main decks (T1 & T2) during peaks hours. Designated off-site parking for students has been identified at the CHOA Administrative Park located on Tullie Circle. Shuttles operate from this location on Monday through Friday, 5:00 AM to 9:00 PM.

      In order to park at the Administrative Center (spaces surrounding the building formerly known as Piccadilly), staff must contact the Egleston Parking Department at 404-785-6696. Advanced notice is required to Julie Sandock, Julie.Sandock@choa.org, in the Security office. Students must complete a car registration form and obtain a decal prior to parking at Piccadilly (Exception: During the weekend or those working an overnight shift, instructors/students may park in either of the main hospital decks. In order to do this, one must pull a ticket and have it validated at the front desk).

      Hughes Spalding

      Clinical Instructors/Faculty/Clinical Groups/Practicum Students cannot park directly at the Hughes Spalding deck. Students and faculty are to park at the Butler deck (148 Jesse Hill Jr. Drive, Atlanta 30303; just past Grady Hospital, next to McDonald's)—enter on visitor side, pull a ticket, and bring ticket with them for validation.

    In the event you have an issue with one of the requirements please contact Lisa Longeiret at nu_medrecords@kennesaw.edu for resolution.

  • Student Information

    • All forms to be completed on-site the first day of clinical (please take driver's license)
    • Bring a copy of your Advantage Students background check and drug screen with you to Orientation
    • Orientation must be completed prior to clinical rotation start date. Your instructor will contact you with further instructions.
  • Student Information

    • Click on assigned camp website and complete Volunteer Application
    • If Letters of Recommendations are required, submit recommendations sealed in separate envelopes with your Camp Application
    • Submit completed applications and letters of recommendations (if applicable) at room 3006 NO FAXES
  • Student Information

    • Print a copy of your full background Check and drug screening from Advantage Students and fax to Pam Houser at 770-220-2979 10 days before your fist day of clinical.
    • In the subject line type: KSU Clinical Background Check and Drug Screening Report.
    • Clinical Paperwork will be completed at the clinical site.
  • Student Information

    DCSB Packet

    Submit completed packet to HR when you go to pick up badge with clinical instructor

    Document Checklist

    Richardson Health Center
    445 Winn Way, 4th Floor
    Decatur, GA 30030
  • Student Information

    Please complete the Background Consent form. Bring a copy of your most recent TB testing along with the completed Background Consent form to be submitted in the office to a credentialing specialist in room 3014.

  • Student Information

    *when signing up with ACEMAPP only use your KSU e-mail*

    Emory is now using ACEMAPP as their credentialing tool. You will receive an e-mail invitation to join this credentialing tool (KSU e-mail address) about one week after you are notified of your placement. If you do not receive this invitation please contact nu_medrecords@kennesaw.edu. The required documents will be in ACEMAPP and the deadlines for completion will be listed on the ACEMAPP site.

    For help with the ACEMAPP, please contact their support team below:
    Email: support@acemapp.org
    Phone: 844-223-4292

    Emory University Hospital Midtown: Badge office hours are M-F 7-3:30 (closed for lunch from 12:30-1:00), located on the F level of the Glenn Building (adjacent to the visitor parking deck). Students are required to find parking in other pay lots. There is a lot at the corner of Peachtree and Pine for $5 per day if in by 9:00 a.m.

    St. Joseph’s Hospital: Your KSU student badge is the only badge required at this location. See ACEMAPP for parking information.

  • Student Information

    *when signing up with ACEMAPP only use your KSU e-mail*

    Floyd Medical Center is now using ACEMAPP as their credentialing tool. You will receive an e-mail invitation to join this credentialing tool (KSU e-mail address) about one week after you are notified of your placement. If you do not receive this invitation please contact nu_medrecords@kennesaw.edu. The required documents will be in ACEMAPP and the deadlines for completion will be listed on the ACEMAPP site.

    For help with the ACEMAPP, please contact their support team below:
    Email: support@acemapp.org
    Phone: 844-223-4292

    Butt

  • Student Information

    Please review and complete the confidentiality form below entirely—form must be submitted to nu_medrecords@kennesaw.edu 

    confidentiality form

    Student nurses need

    • To review and complete the Attached Confidentiality Form, bring with them the first day of assignment
    • To contact the precepting nurse for the exact times to plan on working in that particular school clinic
    • To ask of the best place to park at the assigned school
    • To know that cell phones are to only be used in extreme emergencies at the permission of the Mentoring Nurse
    • To dress in their school uniform, Hair to be professional and no perfumes.
    • To bring a lunch or plan to buy lunch at school (approx. $4.00).
      *Should not leave the school for the 20-30 minute lunch break
    • To come prepared with goals of what they want to learn and accomplish.
    • To know that they will not only observe but will be an active part of the school clinic.
    • To please email or phone the mentoring nurse if the student nurse will be late or not able to attend clinicals.
  • Student Information

    • No special requirements.
  • Student Information

  • Student Information

    1. Download and Review the Orientation documents: Orientation Packet 1 and Orientation Packet 2.
    2. Download and Review the Gordon Hospital Policy Pack.
    3. Download and Complete the Student Packet.
    4. Scan and e-mail documents to nu_medrecords@kennesaw.edu (or bring to room 3014)

    Medical Documents (must be submitted with your clinical paperwork)

    Immunizations

    1. Proof of TB Testing
    2. Proof of TDAP immunization
    3. Proof of Varicella or titer value report
    4. Proof of two MMR immunization or titer value report
    5. Proof of three Hepatitis B immunization or titer value report
    6. Flu Vaccine:
      • Fall semester: flu documentation must be submitted by 2nd Friday in October
      • Spring semester: flu documentation must be submitted with clinical paperwork.

    You can submit page one of your physical, attach additional immunization documents to ensure all above medical requirements are met.

  • Student Information

    UNIVERSAL MASK POLICY
    Grady requires that all persons wear a mask while at the hospital or any of our other locations. For staff (and students), that means a mask must be worn in areas including, but not limited to, hallways, atriums, elevators, patient care areas, the cafeteria and any location where staff cannot safely socially distance. The mask may be an N95 mask, a surgical mask, or a cloth mask that covers the nose and mouth. The mask requirement also applies to patients and visitors. We must all work together to ensure this policy is followed. 

    Students register for Grady Orientation through ACEMAPP on the events tab.* Directions/information regarding this process (and GO in general) is located on the Student & Faculty announcement tab

    1. Complete orientation materials in ACEMAPP
    2. Log into your Advantage account by clicking the Vendors tab in ACEMAPP. Select Grady Health System to share your reviewed results
    3. All students will be required to pay $1.00 badge fee to Grady Hospital before receiving their badge. Community and Practicum Students, badges must be picked up no sooner than 3 days prior to the beginning date of your clinical rotation, you will be unable to begin your rotation without your badge.
    4. Parking - Students will be required to pay a $10 deposit for a hang tag to be displayed in their vehicle while parked at the designated lot.  The deposit will be reimbursed upon turning in the tag

    Maternal Health 3318 Students ONLY:

    • Students will be required to obtain an additional fingerprinting package from Advantage Students. Please follow the directions and your instructor will inform you when you have been cleared. Do not delay, this takes additional time and you will not be able to start your rotation until it has been completed through Advantage. 
    • Choose the selection “Grady Hospital - Intern Fingerprinting” as your school / program, after downloading the advantage student document with the directions.
  • Student Information

    *when signing up with ACEMAPP only use your KSU e-mail*

    Gwinnet is now using ACEMAPP as their credentialing tool. You will receive an e-mail invitation to join this credentialing tool (KSU e-mail address) about one week after you are notified of your placement. If you do not receive this invitation please contact nu_medrecords@kennesaw.edu. The required documents will be in ACEMAPP and the deadlines for completion will be listed on the ACEMAPP site.

    For help with the ACEMAPP, please contact their support team below:
    Email: support@acemapp.org
    Phone: 844-223-4292

  • Student Information

    • Students must return their badge at the end of the rotation.

    • Badge office hours are now 7am to 4pm.

  • Student Information

    Administrative Office
    3830 South Cobb Drive, Suite 300
    Smyrna, GA 30080
    770-429-5000

     

    Cobb County:
    Ready to Work
    Hartmann Center
    Ready to Work Program
    Mothers Making A Change
    Cobb Crisis Stabilization
    Cobb Recover Center
    Dual Diagnosis

    clinical documents to be completed
    1. Read the CDCSB Employee Handbook.
    2. Intern Application
      • 1st Page - Complete the Data Sheet
      • 2nd Page 
        • Name:  Print your name
        • Date: Today's date and day time phone number
        • Dates for placement/internship & Days and time available for placement/internship: begin and end date will be entered for you.
        • School, College, Institution: Kennesaw State University
        • Degree of Certification Desired: BSN Major: Nursing
        • Program Course for which placement/internship is required: 3314
        • Projected Graduation Date: Semester and Year of graduation
        • Answer questions 1-3
        • Do not complete #4 or #5
      • 3rd Page
        • Do not complete this page, but submit with your paperwork
    3. Confidentiality & Technology for Interns – submit only page 2
      • Employee/Volunteer/Intern/Signature: your signature and today's date
      • Print Full Name: Print your name
      • Witness Signature: Have your family of friend to be your witness and date
    4. Release for information – This forms must be fully completed or you will not be able to start clinical
      • Print clearly filing in ALL information
      • Must Include
        • SSN: Your SSN
        • Phone Number: Daytime Phone Number
        • Email: KSU E-mail address
        • Signature of Applicant/Employee: Your signature and date
    5. Drug Free Work Place
      • Print and sign your name
    6. Read the HIPAA Presentation and Complete HIPAA for Intern Test
      • Complete and submit
    7. Read and complete the Infection Control Orientation Packet and Quiz and submit
      • Complete and submit
    8. Check your Infection Control Orientation Quiz & Acknowledgment
    9. Infection Control Signature
      • Employee/Volunteer/Intern/Contractor Signature:  Your signature and date

    Medical Documents
    (must be submitted with your clinical paperwork)

    Documents must be submitted in the office to a credentialing specialist in room 3014.

    1. Current TB Testing within 1 year
    2. Copy of your background check
    3. Copy of your drug screen
    4. Copy of your BLS card
      • You must take to your first facility visit:
        • Social Security Card (passport or birth certificate if student does not have SS card)
        • Driver's License
  • Student Information

    • No special requirements.
  • Student Information

    Bring a copy of your most recent TB testing along with this form to be submitted in the office to a credentialing specialist in room 3014.

    Document Checklist

    • TB Testing documentation
    • Background Driving Record Check Form
  • Student Information

    • No special requirements.
    • Homstead Hospice will contact you with orientation dates.
  • Student Information

    • Kaiser Permanente will contact you 2-3 weeks before your clinical rotation begins.
  • Student Information

    Since the KSU Health Clinic is now part of the WellStar Health System, see WellStar Health System (Kennestone, Cobb, Windy Hill, Paulding, Douglas and First Steps) below and follow the instructions.

  • Student Information

    • Please contact MedSide Healthcare Corporation -  Home Health Administrator Beatrice Coulombe to register for your Orientation.  Orientation must be completed prior to the start date of your clinical rotation.  Orientation is conducted every Monday from 9:30am to 3:30pm. 
    • Complete the attached paperwork fully and bring everything to your scheduled Orientation.

    Document Checklist

    • Authorization to Request Records (2 separate forms, 1 page each)
    • Consent to Photograph (1 page)
    • Post – Offer Health Screen (3 Pages)
    • Chamblee Police Department Criminal History Consent Form (1 page)
    • Confidentiality Agreement (4 pages)
  • Student Information

    No paperwork

  • Student Information

    No paperwork

  • Student Information

    *when signing up with ACEMAPP only use your KSU e-mail*

    Northside is now using ACEMAPP as their credentialing tool. You will receive an e-mail invitation to join this credentialing tool (KSU e-mail address) about one week after you are notified of your placement. If you do not receive this invitation please contact nu_medrecords@kennesaw.edu. The required documents will be in ACEMAPP and the deadlines for completion will be listed on the ACEMAPP site.

    For help with the ACEMAPP, please contact their support team below:
    • Immunizations needed for clinical at NSH
        •  TB - Negative QuantiFERON Gold or T-Spot required, Negative PPD will NOT be accepted.
            • I recommend the Health Department to obtain a current negative TB blood test if you do not currently have one on file.
            • Download and view the flow chart (pdf) for your particular situation.
        • Proof of tetanus immunization
        • Proof of two Varicella or titer value report
        • Proof of two MMR immunization or titer value report
        • Proof of three Hepatitis B immunization or titer value report
    • Students who are also Northside Employees: please follow steps as indicated in ACEMAPP to verify your employee affiliation BEFORE uploading your health documentation.
    • 4417 senior practicum students do not report to your unit before picking up your badge; instructions to do so will be given to you by your clinical instructor.

    Parking and Badges

    • NSH-ATL: all students and faculty are to park at the Orange Parking Deck
    • NSH-CHER: senior practicum students ONLY, please pick up badges from Toni McPherson once you receive clearance for all requirements in ACEMAPP. Call (678-388-6404, 7:30 to 4:00) to make an appointment for badge pickup.
  • Student Information

    Piedmont Healthcare is now using ACEMAPP as their credentialing tool. The required documents will be in ACEMAPP and the deadlines for completion will be listed on the ACEMAPP site. Make sure that your KSU email address is in ACEMAPP.

    Please review this Student Orientation Video for information about Piedmont’s requirements in ACEMAPP.

    *Please note: Piedmont requires an annual background check. If your most recent background in Advantage Students is more than 12 months old at the time you are assigned to a Piedmont rotation, you will need to purchase a new background check. Do not purchase an additional background check until you are assigned to this location by the Student Placement Coordinator.

    Parking Information

    Piedmont Henry is now a pay-to-park facility with designated parking for staff and students.   
    Effective June 1st, the parking lots will be gated, and lots are designated as staff and visitor parking. Visitor parking rates are as follows:

    Up to 20 minutes = Free
    21 mins. – 2 hours = $2
    2 hrs.  – 5 hours = $4
    More than 5 hours = $5 per day

    For students, Piedmont offers parking permits. This permit is valid only for the Orange Lot, which is adjacent to the Education Building. Permits can be obtained through the Parking Office once credentialing is complete in ACEMAPP. The Parking representative will be available Tuesdays and Thursdays from 0900-1200 in the Lobby of the Education Building. The fee is $10 and covers the entire rotation. Lost or stolen permits will incur a $25 replacement fee. Once the rotation is complete, the expectation is for permits to be returned to the Parking Office. 

  • Student Information

    1. Go to http://tcps-us.com
    2. Read and follow the instructions to access your credentialing documents
    3. Badge Pickup: Badges must be picked up from HR (open 8–4) before rotation begins

    Medical Documents
    (must be submitted in ACEMAPP and up to date by the designated clinical documentation deadline)

    1. Front and back copy of your current CPR card
    2. Immunizations
      • Proof of TB Testing
      • Proof of two Varicella or titer value report
      • Proof of two MMR immunization or titer value report
      • Proof of three Hepatitis B immunization or titer value report
      • Proof of Tdap
      • Current Flu documentation (Oct 1st to March 31st)

    Clinical Requirement Checklist

    Students need the following requirements met:

    • Negative Back Ground Check – share with Redmond
    • Negative Drug Screen- share with Redmond
    • Hand Hygiene Compliance Form (send to Stacy Lynn Richardson  srich129@kennesaw.edu)
    • (Oct 1st to March 31st)

    Passing score of all 3 items listed below:

    • TCPS FERPA Release & Confidentiality Agreement AY2021-2022
    • Nursing, MD & PA General orientation Quiz AY2021-2022
    • HealthCare General Orientation Quiz AY2021-2022
    • Redmond Regional Medical Center Attestation AY2021-2022
  • Student Information

    Document Checklist

    • Orientation workbook post test
    • Dress code acknowledgment form
    • HIPAA Training Manual Agreement
    • Confidentiality Agreement
    • Key form
    • Positive Impact form
    • Personnel Record
    • Parking Permit form
    • Background Check Release Form
    • Copy of your Covid-19 Vaccination documentation
  • Student Information

    Follow the steps below after you receive your placement from Lillian Valdez

    1. You will be receiving an e-mail from Glenn Prescott informing you of the clinical requirements and vetting process for the Shepard Center.
    2. Please ensure that you reply to his e-mail immediately and copy nu_medrecords@kennesaw.edu
    3. The directions above are for 1st and 2nd group rotations.

    You will not be allowed to start clinical until you are cleared by Employee Health at Shepherd’s.

    Minimum requirements include:

    • National Criminal and sex offender search (7 years)
    • OIG/GSA + OFAC – a combined search of the Office of Inspector General and the general Service Administration is searched for any individuals that has committed any type of fraud against Medicare, Medicaid or other Federally funded healthcare program. Plus, a search of the Office of Foreign Assets Control.

    Health Screening: schools must be performing at least one drug screen, checking immunizations, and providing Hepatitis B vaccine/education. Minimum requirements include:

    • Negative drug screen testing result
    • Two MMR vaccines or titers for Measles, Mumps and Rubella
    • Two Varivax Vaccines or history of the chicken pox
    • TB test within the last 90 days before placement
    • Current flu shot if placed during active flu period as determined by the CDC
    • Hepatitis B vaccine and/or education provided
  • Student Information

    Each camp has specific requirements, you will receive an email from the course coordinator with further instructions for the camp you are assigned.

  • Student Information

    *when signing up with ACEMAPP only use your KSU e-mail*

    As of Fall 2017, WellStar is transitioning to ACEMAPP. You will receive an e-mail invitation to join this credentialing tool (KSU e-mail address) about one week after you are notified of your placement. If you do not receive this invitation please contact nu_medrecords@kennesaw.edu. The required documents will be in ACEMAPP and the deadlines for completion will be listed on the ACEMAPP site.

    1. Review the Infectious Disease Preparedness Protocol—Healthcare Worker Travel Screening
    2. 4412 & 4417 (only) Please note students must obtain a badge prior to 1st clinical rotation.  Contact Kennestone Security at 770-793-7780 to make sure it is ready for pickup. Other WellStar Hospital Security Departments also prepare badges and if you are working at one of these facilities you may be able to pick your badge up there. Students in other clinical groups—your Instructor will pick up your badges for you.
    3. Students must bring a copy of their proof of flu vaccination to WellStar Security for badge pickup. 
    • WellStar Atlanta Medical Center Security
      • Step 1: Room 315 building 1st floor
      • Step 2: Parking office 340 building 3rd floor
    • WellStar Kennestone Security
      770-793-7780

    • WellStar Cobb Security
      770-732-3990

    • WellStar Douglas Security
      770-920-6261

    • WellStar Paulding Security
      770-505-7168

    • WellStar Windy Hill Security
      770-644-1155

    Professional Appearance

    1. Check with your unit to see if they have any specific dress requirements
    2. WellStar badges must be worn at all times while on campus
    3. Artificial nails cannot be worn by employees providing patient care and/or the processing and management of patient care equipment, medical or food. Artificial nails include any substance or device applied to natural nails to augment or enhance nails. They include, but are not limited to, bonding, overlays, inlays, wraps, tips and/or attached decorations
    4. WellStar nurses are identified by wearing navy blue. Students will wear their school uniforms

    Parking Information

    *Practicum Students ONLY—do not pick up your badge until 3–5 days of your rotation start date

    student badge and parking reference

    Thank you and we look forward to your clinical time at WellStar!

  • Student Information

    No paperwork

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