As a student/resident, I understand that I may have access to confidential medical or business information, both clinical and employee related, through written records, documents, ledgers, internal verbal correspondence and communications, and computer programs and applications. I agree not to divulge or disclose to anyone other than those persons of St. Claire Regional Medical Center who are identified by written policy as having the "need to know" directly or indirectly, either during of after my internship/coop/shadowing/observation/med-student/resident experience, any confidential information acquired during the course of my experience. I understand and acknowledge that, in the event I breach any provisions of this agreement, St. Claire Regional Medical Center, in addition to any other legal remedies available to them, has the right to reprimand, suspend, and/or terminate my education experience with or without notice at their discretion. By providing my digital signature below, I hereby agree to the conditions listed above.

The Medical Education Lab business hours are 8:00 a.m. to 4:30 p.m. Monday thru Friday.  AHEC student badges are to be worn at all times while in the lab.  Use of PCs for Internet access, or creation of papers, presentations, etc. is a privilege not a right. Computer settings, passwords, and installed programs are neither to be copied nor altered in any way. The computer lab, providing there are no training classes scheduled, will be available to you during normal business hours as well. Do not save any documents/assignments on the PCs as they will be deleted each day. The PCs are networked to the copy/printing machine located in the library. You may copy/print during regular business hours. Copying articles and printing out assignments, presentations and such is also a privilege not a right. Anyone caught copying or printing anything other than class materials will have copying privileges taken away. The copier will be available during normal business hours only. Food and drinks are permitted. Please be careful if you are eating and/or drinking while working on the PCs. We all know what spilled drinks can do to a computer. Please throw all trash away when you are finished. Literature searches and digital materials are available to you. Please email Sue.russell@st-claire.org if you have any questions about these services. The lab is to be kept locked before 8:00 a.m., after 4:30 p.m., on weekends and holidays. All authorized personnel are issued an entry code for admittance during this time. Persons without authorization are not to be admitted by students or others.  Violations of this agreement may be reported to the AHEC office and/or appropriate school officials. By providing my digital signature below, I certify that I have read, understood, and agree to abide by all of the above:

I agree to return the security badge, badge and badge buddy which has been assigned to me for my use during my rotation at St. Claire Regional Medical Center. I further agree to pay the cost of the badge in the event that I should lose or damage it. That cost is $6.00 for replacement if not returned. If I lose my badge and need to reprint it, the cost will be $10.00. You may return badges to the AHEC office Monday – Friday from 7am – 4:30pm or we have a drop off box outside the medical library door located on the 2nd floor of the hospital. Please make sure these are returned when you leave or we will have to contact your program coordinator.

The Medical Education Lab business hours are 8:00 a.m. to 4:30 p.m. Monday thru Friday.  AHEC student badges are to be worn at all times while in the lab.  Use of PCs for Internet access, or creation of papers, presentations, etc. is a privilege not a right. Computer settings, passwords, and installed programs are neither to be copied nor altered in any way. The computer lab, providing there are no training classes scheduled, will be available to you during normal business hours as well. Do not save any documents/assignments on the PCs as they will be deleted each day. The PCs are networked to the copy/printing machine located in the library. You may copy/print during regular business hours. Copying articles and printing out assignments, presentations and such is also a privilege not a right. Anyone caught copying or printing anything other than class materials will have copying privileges taken away. The copier will be available during normal business hours only. Food and drinks are permitted. Please be careful if you are eating and/or drinking while working on the PCs. We all know what spilled drinks can do to a computer. Please throw all trash away when you are finished. Literature searches and digital materials are available to you. Please email Sue.russell@st-claire.org if you have any questions about these services. The lab is to be kept locked before 8:00 a.m., after 4:30 p.m., on weekends and holidays. All authorized personnel are issued an entry code for admittance during this time. Persons without authorization are not to be admitted by students or others.  Violations of this agreement may be reported to the AHEC office and/or appropriate school officials. By providing my digital signature below, I certify that I have read, understood, and agree to abide by all of the above:

I attest that I have read the information provided to me in the Student/Resident Orientation Overview literature.  I understand that I am responsible for the content in its entirety.  Furthermore, while on rotation at UK-St. Claire or any of its facilities,I will uphold the values and follow the guidelines for acceptable behavior as described in the overview literature. By signing below, I acknowledge I have read and understand all information in the Student/Resident Orientation Overview. I understand that I can be dismissed from clinical rotation should it be determined that I did not follow the guidelines or policies defined in the overview. I acknowledge I can be asked to leave UK-St. Claire immediately without cause. I have provided the Northeast KY AHEC and UK-St. Claire the information listed below and is required prior to reporting to my rotation site. Failure to provide any information listed below will result in not participating in the rotation.

The following documentation is required for all students rotating at St. Claire Regional Medical Center:

• A Letter from the institution stating that the student/resident is in good standing
  • Letter must be addressed to Jessica Caudill, Student Services Coordinator, typed on letterhead, include students name, rotations dates and signed by the one administering the letter
• Criminal/Caregiver background check that shows the student does not have any past history of drug abuse, felony, etc
• Drug screen results showing a negative
• Immunization and health records showing 2 MMR’s or titers drawn showing immunity, compliant with CDC recommendations
• Results from a two-step TB Skin Test is required and consistent with CDC guidelines for SCR. These are 2 separate tests with the second test administered within the last year of rotation start date and the first test administered within the last year of the second one. This type of testing is compliant with CDC recommendations for SCR. If you have never had a TB skin tests done, please allow at least a 2 week time frame for both tests to be administered before you start your rotation.
• Annual flu shot has been administered during the flu season time frame of October 1 – March 31. (Must provide a copy for SCR employee health reporting.)
• Copy of  COVID-19 vaccine card only if received between September 2023-present.

If your institution does not provide the NE KY AHEC with this information, you must submit your documentation below.