If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Information to come.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, and unit.

Step 2: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 3: USF Clinical Coordinator will send all student preceptor information to Ms. McKinney for their record.

Step 4: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 5: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement. Time sensitive, must be submitted 3-4 weeks before the semester starts! With the holiday, it will need to be more.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: The USF Clinical Coordinator will email Ms. Christine Reeves (christine.reeves@ahss.org) all students names and contact information.

Step 2: Students will need to complete the following forms and submit them via email to the USF Clinical Coordinator. Be advised that some elements are "N/A" due to exclusion of direct patient care activities.

Note: Incomplete and/or illegible documents will delay processing and rotation start. 

Current employees should already have these forms up to date in the FH-Carrollwood system.

• Non-Employee OPID Form: https://usf.box.com/v/FHCarrolOPID19
• Form Request for Student Placement FHCW: https://usf.box.com/v/FHCarrolRequestStudPlacement
• Student Confidentiality of Information Agreement: https://usf.box.com/v/FHCarrolConfidentiality
• Student Orientation Checklist: https://usf.box.com/v/FHCarrolStudOrient

Step 3: Students must schedule a time to briefly meet with Ms. Reeves for your orientation to Carrollwood, regardless if you are already an employee. Email her at christine.reeves@ahss.org.

Step 4: The USF Clinical Coordinator will submit your completed paperwork on your behalf to Ms. Reeves.

Step 5: It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit. Ms. Reeves can clarify for you.

Step 6: Students must communicate their preceptor's name and contact information via email to your USF Clinical Coordinator (asanford@health.usf.edu).

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: The USF Clinical Coordinator will contact Ms. Elizabeth Celeste (elizabeth.celeste@ahss.org) to see if their facility can accommodate students for the semester requested.

Step 2: Students must identify a preceptor for their experience. The hospital mandates that the preceptor cannot be a student's direct supervisor and the student must receive consent from the preceptor that they are willing and available to complete the hours with them.

Step 3: Students must email Ms. Edna Thomas (edna.thomas@ahss.org) for preceptor approval and next steps in the hospital's process for onboarding students.

Step 4: Students must communicate their preceptor's name and contact information via email to your USF Clinical Coordinator (asanford@health.usf.edu).

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Student must email the USF Clinical Coordinator (asanford@health.usf.edu) with the following information:

• Preference of learning experience, departments, etc.

Step 2: The USF Clinical Coordinator will email Ms. Kate Dorminy (katherine.dorminy@flhosp.org) all student's information, number of hours, deadline to complete hours, and student preferences.

Step 3: Ms. Dorminy will assign you a preceptor at the facility. Please watch for an email from her, she will send the information to your USF Health email.

Step 4: Students must communicate their preceptor's name and contact information via email to your USF Clinical Coordinator (asanford@health.usf.edu).

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Per Ms. Marva Green, employees that enroll in the RN to BS Program with USF should contact her directly. Email her at Marva.Green@ahss.org as soon as possible, and she will provide you with the required documents needed to secure your placement.

Step 2: It is the student's responsibility to secure a preceptor for your experiential learning (service learning) practicum hours. The hospital mandates that a student's preceptor cannot be their direct supervisor. If you need assistance in choosing a preceptor, you can contact Marva Green.

Step 3: Students must communicate their preceptor's name and contact information via email to your USF Clinical Coordinator (asanford@health.usf.edu).

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Student is required to email Ms. Laura Dorner (laura.dorner@ahss.org) directly to receive the forms required to secure placement for the semester requested.

Step 2: It is the student's responsibility to secure a preceptor for your experiential learning (service learning) practicum hours. The hospital mandates that a student's preceptor cannot e their direct supervisor.

Step 3: Students must communicate their preceptor's name and contact information via email to your USF Clinical Coordinator (asanford@health.usf.edu).

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: USF Clinical Coordinator will verify with the facility if they are able to accommodate the placement request. USF Clinical Coordinator will share the following information with the facility: Student name(s), whether they are an FH employee, school, degree, expected start and end dates, hours, FH campus, unit and student's preceptor assigned.

Step 3: USF Clinical Coordinator will send an email to student(s) approved for placement at this facility. Students are then required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 4: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization only accepts their employees for student placement.

If you are a current employee/team member at this location, you are eligible to complete your experiential hours (service learning) at this facility if you complete the following and return to the USF Clinical Coordinator:

Step 1: Students are required to send the following information to the USF Clinical Coordinator via email (asanford@health.usf.edu):

• Your Campus (which facility, not USF)
• Your unit
• Your preceptor's name and contact information
  • It is the student's responsibility to secure an appropriate preceptor for your experiential learning (service learning) practicum hours. It cannot be your immediate supervisor, and generally cannot be on your unit.

Step 2: Students are required to complete the following yellow portions on this form and return to Ms. McKinney (jennifer.mckinney@flhosp.org) directly. Do not send sensitive SSN information to the USF Clinical Coordinator.

• https://usf.box.com/v/BadgeRequestForm

Step 3: The USF Clinical Coordinator will email Ms. Jennifer McKinney (jennifer.mckinney@flhosp.org) with related information such as date, hours, campus, unit, and preceptor assigned.

This facility/organization will accept non-employees for student placement. Affiliation Agreement in process

If you are a current employee/team member at these locations, you are eligible to complete your experiential hours (service learning) at these facilities if you complete the following and return to the USF Clinical Coordinator:

Step 1: Student must note that all USF RN-BS students/current employees at this site must keep all Health, Safety and Security requirements in a student file via an account with Complio from American Databank. MHS employees have the ability to upload a copy of their employee badge in lieu of paying the $150 cost (only $10 remaining for remaining responsibilities in online system). Non-Employees will have to pay the additional $150 to start an account on Complio.

Note: MHS employees' badge helps satisfy most of the requirements in Complio. These students can on-board themselves one month before the start of the rotation. Non-Employees are recommended to start 2 months in advance from the start of their rotation.

Step 2: Students must satisfy the required immunizations:

• MMR (2) or titers
• Hep B (3) or titers (for healthcare worker only). MHS Hep B declination form will be accepted.
• TDap or Td within the last 10 years
• Varicella or titers or documentation of disease

Step 3: Students must complete a health screening including negative PPD OR proof of a positive PPD along with negative chest X-Ray dated after the positive PPD on file and an MHS signs and symptoms attestation form dated within the last 365 days. No quantiferon gold.

Step 4: Student must complete an 8 panel drug test or higher

Step 5: Students must satisfy the required background check information:

• Tri county (Broward, Miami Dade, Palm Beach) background check
• State/FDLE background check
• National background check
• Sexual Predator background check
• OIG Sanctions & Exclusions Check
• Employment verification – the last year
• Fingerprinting (depending on the type of student)

Step 6: Student must satisfy the Flu Shot requirement (seasonal November 1 to March 31). Declination form will be accepted but must wear a mask at all times.

Step 7: Student must satisfy the BLS for Healthcare providers requirement (if working in an area with patients).

Step 8: It is the student's responsibility to secure an appropriate preceptor. See guidelines above for details. Note: preceptors cannot be the student's direct reports, nor can it be on the student's floor/unit/department.

Step 9: Students must communicate their preceptor's name and contact information via email to your USF Clinical Coordinator (asanford@health.usf.edu).

No student can on-board until the Affiliation Agreement is completed.