Get Application For Clinical Placement - Lehman College - Lehman

Filling out the Application For Clinical Placement is an essential step for students in the graduate nursing program at Lehman College. This guide will provide you with a clear and structured approach to completing the application form online, ensuring that you include all necessary information.

Follow the steps to successfully complete your application online.

1. Click the ‘Get Form’ button to access the application form for clinical placement.
2. Begin by filling in the ‘Date’ field with the current date.
3. Input the ‘Course Name and Number’ accurately as it corresponds with your program.
4. Provide your full ‘Student Name’ in the designated field.
5. Fill in your ‘Student Address’ completely with the correct details.
6. Enter your ‘Student Phone Numbers’ including home, cell, and job numbers.
7. Input your official ‘Student Lehman E-Mail Address’ for further communication.
8. Specify your ‘Major/Course’ relevant to your study program.
9. Fill in the ‘Clinical Site’ where you wish to be placed.
10. Provide the ‘Contact Name’ of the manager or administrator at the clinical site.
11. Complete the ‘Mailing Address’ to ensure proper correspondence.
12. Enter the ‘Phone Number’ of your contact at the clinical site.
13. If applicable, fill in the ‘Fax Number’ for the clinical site.
14. Provide the ‘Preceptor Name and Title.’
15. Fill out the ‘Preceptor Phone Number’ for easy communication.
16. Input the ‘Preceptor E-Mail Address’ for electronic correspondence.
17. Describe the ‘Unit/Address of Actual Clinical Rotation’ where you will be assigned.
18. Select the ‘Semester Requested for Placement’ by checking the appropriate box (Fall 2015, Spring 2016, Summer 2016).
19. Review the form to ensure all information is correct and complete. Make sure you have all documents required by the Nursing Department: malpractice insurance, BCLS certificate, health clearance form, NYS registered nurse license, and registration.
20. Upon completion, you may choose to save your changes, download the document, print it, or share it as necessary.

Complete your clinical placement application online today!