Get Promedica Student Attestation Form 2017-2025

This guide provides step-by-step instructions for effectively completing the ProMedica Student Attestation Form online. By following these steps, you ensure a clear understanding of the requirements and responsibilities outlined in the form.

Follow the steps to complete your attestation form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in your name in the 'Student Name' field. This should reflect your official name as it appears on your identification.
3. Provide a valid phone number in the 'Student Phone #' field. Ensure that the number can receive calls for any necessary communication.
4. Enter your email address in the designated field. This should be an email you check regularly for important updates.
5. Specify the name of your school in the 'School' field. This should be the institution from which you are completing your studies.
6. Indicate whether this is your first time at a ProMedica facility by selecting the appropriate options under 'ATTESTATION OF ORIENTATION MODULE COMPLETION'.
7. If applicable, indicate if you have attended a ProMedica facility in the same academic school year. If not, check the boxes for the required modules.
8. Review the objectives outlined in the section on curriculum integration. Ensure you are familiar with these concepts before proceeding.
9. Sign in the provided space to confirm your understanding and agreement with the content covered during your school program or orientation.
10. Type your printed name below your signature to verify your identity.
11. Indicate the date when you are completing the form.
12. Once completed, print, sign, and return this form to your instructor, clinical preceptor, or placement coordinator prior to starting your learning experience at ProMedica.

Complete your ProMedica Student Attestation Form online today to ensure you meet all requirements for your clinical experience.