Get Kaiser Health And Safety Verification Form For Student Cohort 2020-2025

This guide will assist you in completing the Kaiser Health And Safety Verification Form For Student Cohort online. By following these steps, you can ensure that all required information is accurately provided for your health and safety verification.

Follow the steps to effectively fill out your form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the school name in the designated field at the top of the form. This identifies the institution associated with this verification.
3. Indicate the type of student by selecting either 'RN' or 'Other' using the checkbox provided.
4. Fill in the semester during which you will be participating in the cohort.
5. Provide the faculty name, license number, and faculty contact information, including phone, pager, and email addresses.
6. Specify the scheduled days of the week that you will be in attendance.
7. Enter your last name and first name in the corresponding fields to identify yourself.
8. Detail your rotation dates and expiration date for your verification.
9. Fill in the scheduled start and end times for your rotations to provide clarity on your schedule.
10. List the course name and number to correlate your verification with the appropriate academic program.
11. Complete the vaccination history section by filling out the dates for the TB test (x2), Hepatitis B titers or 3 vaccinations, Varicella titer or 2 vaccinations, and MMR titers or 2 vaccinations.
12. Make sure to include the faculty associated with each rotation and their license or certificate number.
13. Affirm the accuracy of the information provided by sealing it with your verification and date in the designated space.
14. Ensure that all required attachments and necessary checks like seasonal flu date, Tdap date, AHA BLS expiration date, criminal background check, and drug screening (if required) are included.
15. Review your form thoroughly for completeness and accuracy. Once finalized, you have the option to save changes, download, print, or share the form.

Complete your Kaiser Health And Safety Verification Form online today to ensure your eligibility for the student cohort.