Documentation of the following must be on file in the CNC and current. It is the student's responsibility to bring in documentation of services received elsewhere for placement in their health file in the CNC. CNC personnel will update the Yellow Card upon receipt of new information.

1. TB Skin Test
• Tuberculin skin test within six months prior to clinical program is required. If the student provides written documentation of a negative TB skin test completed within the last 12 months, a one-step is required. If no TB skin test has been completed within the last 12 months, then a 2-step is required.
• The one-step is required annually thereafter.
• Students with a history of positive reactions to TB skin tests must have a Quantiferon blood test. If positive, they will need to have a symptom review by a qualified health care provider annually. A chest x-ray may also be required.
  
  
2. Tetanus Booster (Tdap)
• Required to be done every 10 years.
  
  
3. Measles/Mumps/Rubella (MMR)
• Immunity must be proven by either:
  • Written proof of 2 MMR vaccines
  • Positive Titer
    
    
4. Hepatitis B
• Hepatitis B vaccination series must be initiated prior to the start date of student's first clinical course and completed within 6 months of enrollment in that course.
• Six weeks after the 3rd dose a Hepatitis titer must be drawn to confirm immunity. If negative, the series needs to be repeated.
• If the 3rd dose was received greater than 6 weeks prior to program entry, no titer is required.
  
  
5. Varicella
• Documented proof of one of the following:
  • Receipt of 2 doses of live Varicella vaccine at least 30 days apart as an adult or 1 dose under if under age 13.
  • Positive Varicella Titer
    
    
6. Essential Functions
• Form signed by the student must be on record verifying that the student can perform all the essential functions expected of an allied health student.
  
  
7. Physical Exam
• A physical exam within 1 year of entry into the first clinical course by a qualified health provider is required. An OB/GYN exam does not meet the requirement.
  • Dental Hygiene / Assisting students need a dental exam prior to entry into clinical.
  • Central Service students do not need the physical exam - they are touring only.
    
    
8. Allergies
• Students will be screened for all allergies, including Latex, by the CNC using the Allergy Sensitivity form. If an allergy is suspected, it is recommended that the student see an allergist. The student will be given educational materials from the CNC and must sign a waiver.
  
  
9. Student Refusals
   • Students who cannot or will not meet the above health requirements must be referred to the Associate Dean for follow-up. Clinical agencies will need to be contacted regarding student placement by the Associate Dean. Placement cannot be guaranteed.

All of the above documentation / forms need to be hand delievered to the Community Nursing Clinic before the start of your clinical program. Please make copies of your records before delivering to the Clinic.

Please call the Community Nursing Clinic 262.695.1888 to schedule an appointment for any of the above tests. The clinic is located in the Service Building.

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