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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:  
Confidentiality
Drug-Free Workplace
Equal Employment Opportunity
Equal Opportunity/Harassment Issues
Falls
HIPAA
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
Right-to-Know

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

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