Documents you need before clinicals start

Why sites ask for these documents

Clinical sites keep patients, staff and students healthy and safe, so everyone who works with patients meets the same health and training requirements, students included. CDC’s guidance for health-care personnel counts students and trainees as part of the health-care workforce, and PA accreditation standards ask programs to base their immunization and health screening policies on CDC recommendations.

Your school sets a core list, and each clinical site can add its own items and deadlines. The sections below cover what most lists include, so you can start gathering records before the official packet arrives.

Immunizations

CDC and its Advisory Committee on Immunization Practices advise these vaccines for health-care personnel. Most schools ask for proof of each one:

Gathering your vaccine records

Start with the records you already have: a childhood immunization card, your state’s immunization registry, records from a past employer’s occupational health office, or your primary care provider’s chart. Schools usually ask for official documents that show the vaccine and the date, so a signed record or registry printout works better than a handwritten list.

If records are missing, a titer, a blood test that shows immunity, is a common way to document MMR, varicella and hepatitis B. If a titer shows you need another dose, your health care provider and your school will guide you through what to do next. Some steps take time: the hepatitis B series spans several months, for example, so begin as soon as you see a gap.

TB screening

The 2019 recommendations from CDC and the National Tuberculosis Controllers Association ask that all U.S. health-care personnel have baseline TB screening when they start. Baseline screening has three parts: a short individual assessment of your TB history and any past exposure, a symptom evaluation, and a TB test for people without a documented history of TB disease or latent TB infection. The test can be a TB blood test, called an interferon-gamma release assay (IGRA), or a TB skin test. A skin test needs a second visit to read the result, so plan for both visits.

After the baseline, the 2019 recommendations do not call for routine yearly TB testing unless there is a known exposure or ongoing transmission at a facility. Instead, health care facilities provide TB education to all personnel every year. Some schools and sites still ask for a yearly test or a yearly symptom questionnaire, so follow the list you are given.

If you have had a positive TB test before, share that record with your school. Under CDC guidance, a person with a newly positive result has a symptom evaluation and a chest X-ray, and your health care provider talks with you about next steps. Keep those reports with your other documents.

BLS certification

Most schools and sites ask for American Heart Association Basic Life Support (BLS) for healthcare professionals. The AHA offers it as a classroom course or in a blended format that pairs online learning with an in-person, hands-on skills session. When you finish, you receive a course completion eCard that is valid for two years.

Check the expiry date against your whole clinical calendar, not only your next course. If your card would lapse partway through a rotation, renew it before the rotation begins. Some acute care, emergency and pediatric rotations also ask for Advanced Cardiovascular Life Support (ACLS) or Pediatric Advanced Life Support (PALS), and your site will tell you if it does.

Background check, drug screen, license and ID

These items confirm who you are and that you are cleared to work with patients:

• Background check: your school tells you which company to use and what it covers, often criminal history and the lists health-care employers check before someone works with patients. Some sites ask for their own check as well.
• Drug screen: usually a test at a collection site within a set window before your start date, so book it when your school or site tells you, not earlier.
• Nursing license: if you are an RN in a graduate nursing program, you need an active, unencumbered RN license that is valid in the state where your clinical hours take place, either a license in that state or a multistate license that the state recognizes.
• School ID: your student ID or clinical badge identifies you as a student at the site, and many sites ask you to wear it every day.

HIPAA training

You will see real patient information, so schools and sites ask you to complete HIPAA privacy training before you start, and many sites have their own module too. HHS explains that HIPAA counts training programs, where health-care students learn under supervision, as part of a provider’s health care operations. That is what allows sites to share with you the patient information your learning needs.

In return, you keep that information private. Leave names, dates of birth and other identifiers out of your papers, case presentations and clinical logs unless your program says otherwise, never take photos of patients or records, and talk about patients only with the care team and your faculty.

Site-specific onboarding

Once your placement is approved, the site sends its own onboarding. Common items include:

• A badge or ID photo, and building or parking access.
• EHR training and a login, so you can document under your preceptor.
• Orientation modules on topics such as infection control, fire and safety procedures and patient privacy.
• A respirator fit test, at sites where staff wear N95 respirators.
• Signed confidentiality statements, a dress code and a student handbook for the site.

Build your checklist and keep it current

One organized checklist turns a long list into a few calm afternoons:

1. 1Gather both listsCopy every item from your school’s handbook and your site’s onboarding packet into one checklist.
2. 2Add four columnsFor each item, note the date completed, the expiry date, where you submitted it and when it was confirmed.
3. 3Keep copies in one folderSave each document as a clearly named file, such as “Lastname BLS eCard 2026”, in one folder you can open from any device.
4. 4Watch expiry datesYour flu vaccine renews every year and your BLS card every two years. Set a reminder well before each date so nothing lapses during a rotation.
5. 5Submit early and confirmUpload or send documents as soon as you have them, and check that your school or site marked them as received.

Questions students ask