Student Placements Clinical Instructor Requirements

Click blue text for links to information, forms and eCourses. Where indicated, submit requirements via email to

Background Check, Drug Screen, Immunizations, Vaccinations, and TB Screening:
The instructor’s school will maintain background check, drug screen, immunizations, vaccinations, and TB screening documentation. These documents must be available to Scripps Health for review at any time. It is the instructor’s responsibility to review the requirements below and ensure the school has the correct documentation on file at all times.

• Required immunizations (proof of immunizations or immunity titers):
   a. Measles, mumps, and chicken pox
   b. Hepatitis B (declination form accepted)
   c. Tetanus and Diptheria Pertussis
• Flu vaccination (proof of current year vaccination or declination form):
   d. Review the 2017-2018 Flu Vaccination Requirements for Students and Faculty
• Tuberculosis screening:
   e. Negative TB reactors: Mantoux (PPD) TB skin test or TB blood test with negative result within 12 months of beginning clinical experience

Skills Validation:
Skills validation is completed at Scripps Patient Care Provider Orientation (PCPO). It is held at Scripps Memorial Hospital, La Jolla and is two hours. An instructor badge is required for attendance. To schedule PCPO and receive a badge, send an email with the following information:
• First and last name:
• Last four digits of SSN:
• Date of birth MM/DD/YYYY:
• School name:
• Clinical rotation start date:
• Clinical rotation site:
• Do you have a Scripps corporate id? If yes, what is the number?
• Preferred email for us to contact you:

Confidentiality Form:
Review Scripps Confidentiality and Nondisclosure Agreement then submit via email.

Student and Clinical Instructor Protocol:
Review Student Injury Protocol for Instructors.

Epic EMR Documentation eLearning:
Once requirements are met, an email will be sent with Epic eLearning information.

Computer Access Information:
Access is requested once requirements are met. An access email with Scripps login information will be sent approximately one week prior to the clinical rotation start date.

Student Orientation Record: Complete the Student Orientation Record (SOR) and upload it to the Consortium via the “add forms” function (the school representative can do this for you) prior to the start of your rotation.

Student Orientation Checklist: Complete the Orientation Checklist and upload it to the Consortium via the “add forms” function (the school representative can do this for you). If the checklist is not returned, the instructor will not be permitted to begin another rotation until received.


Things to consider:

  1. Student name(s) must be listed in the Student Name(s) section of the request. Names do not need to be entered in the initial request; however, names must be entered no later than three weeks prior to the start of the rotation.
  2. If a placement is a rollover from the previous year, please remember to check that the contact information listed in the bottom portion of the request is up to date and accurate.
  3. Be sure that all of the placement details are correct. The start and end dates in the consortium should reflect the time period in which the students will be at Scripps, not the duration of the class they are enrolled in. The start date listed should be the clinical start date.
  4. Scripps employees that are also students must complete all student requirements including background check and drug screen.

Exit survey

On the last day of your rotation, please complete the exit survey below. We value your feedback regarding your educational experience.