Student Nurse Health Screening and Regulatory Requirements

To ensure safe patient care and ongoing regulatory readiness, it is important that all students meet specific requirements based on Penn Medicine policies and procedures. Students must meet all compliance requirements before they are cleared to come on site at each hospital. We request that you send validation that each student in the program meets each of these requirements.

Please complete these forms for each group of students you are placing.

• Letter for Proof of Immunization
• Health Screening and Regulatory Requirements Form
  • IMPORTANT: The Health Screening and Regulatory Requirements Form must be received by the respective entity representative listed below prior to the start of the clinical rotation.

Then email the forms to the institution representative for which you are requesting:

• Hospital of the University of Pennsylvania
  Barbara A. Todd, DNP, ACNP-BC, FAAN
  Email: Barbara.Todd@pennmedicine.upenn.edu
  Phone: 215-720-9864
• Pennsylvania Hospital
  Alison Schlegel, MSN, RN,MEDSURG-BC
  Email: PAHNsgStudCoord@pennmedicine.upenn.edu
  Phone: 215-829-8457
• Penn Presbyterian Medical Center
  Mary Ann Jones, MSN, RN, CRNP, CNS, CCRN
  Email: Maryann.Jones@pennmedicine.upenn.edu
  Phone: 215-662-9087
• Good Shepherd Penn Partners
  Chelsea Flick Roderiguez, MSN, RN, PCCN-K
  Email: Chelsea.Flick@pennmedicine.upenn.edu
  Phone: 215-893-2577
• Penn Care at Home & Hospice
  Christine Bossone, MSN, RN
  Email: Christine.Bossone@pennmedicine.upenn.edu
  Phone: 610-747-3400