Student Signature Page
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Student Signature Page

Student Name:
School Name:
Instructor Name:
Instructor's Phone:
Anticipated Start Date at BMC:
I have read the on-line Student Orientation provided by Broadlawns Medical Center and understand the following topics: Electronically initial when completed.
For ALL students:  
Drug-Free Workplace
Equal Employment Opportunity
Equal Opportunity/Harassment Issues
National Patient Safety Goals
Patient Rights
Radiology Exposure
Safety Procedures
Service Excellence
Sexual and Other Types of Harassment
Statement of Mission, Vision and Values
Student Guidelines
Tobacco-Free Environment
For students in clinical internships - individual or group:  
Drug Addiction in Healthcare Professionals
Infection Control
Mandatory Reporting
Multiculturalism in Healthcare

I will cooperate fully in following the health care organization's policies and protocols.

Student's Signature (Electronic)
1801 Hickman Road, Des Moines, IA 50314-1597 | Phone 515-282-2200
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