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Department of Nursing Clinical Health Requirements

All students assigned to a clinical experience in any CT agency must be able to produce the following information within 24 hours if requested by the agency:

• Health attestation statement from student’s health care provider, based on satisfactory  physical examination within 12 months of the rotation
• Record of immunization for measles, mumps and rubella (MMR), if  born after January 1, 1957
• Record of non-reactive PPD (Mantoux)( not more than one year old), or documentation of  treatment and resolution of active TB episode
• Record of current varicella (chicken pox) titer if unsure if s/he has had varicella.
•  Hepatitis B immunization or written declination
• tetanus booster within 10 years
• Proof of comprehensive health insurance coverage
• Current CPR card

Westchester Medical Center

All students assigned to WCMC must:

• use the WCMC form:
  Health clearance form signed by health care provider
  Rubella titer lab results and if negative vaccination dates     
  Rubeola titer lab results. If negative then must provide documentation of 2 vaccination dates
  PPD/Mantoux
  HbsAb (Hepatitis) Positive results or negative results with dates of immunization or declination of vaccine
  Varicella titer highly recommended for WMCH: required for those assigned to Blythdale
• Proof  of  comprehensive health insurance coverage
• Current CPR card

Students are responsible for maintaining the clinical health requirements of the agencies and meeting any and all obligations. Failure to comply with agency requirements means that you (the student) will not be allowed into the clinical areas.