Aurora Student Clincal Placement - Mid Market Smart Chart Documentation

Green Bay Healthcare Alliance

Aurora Baycare is proud to be partnering with the Green Bay Healthcare Alliance to find the best ways to make student placement seamless and similar from one clinical site to another.

Please follow the instructions which will refer you to the Green Bay Healthcare Alliance Website:

Forms and education discussed below are all found on the above website except for the EPIC login and Minimum Necessary forms which can be found here.

Step 1:

From the website, the Instructor should complete the Clinical Request Form and submit to the contact person.

Step 2:

The clinical site will verify with the college the hospital's decision to accept or decline the request for placement.

Step 3:

The Student will

  • complete the education modules on the website (HIPAA, Safety, Infection Control)
  • complete the health requirements. Students who choose not to have an Influenza Vaccination must submit a request to decline for a medical or religious reason.
  • will meet all other requirements on the Affiliation Verification form.

The college will

  • complete the criminal Background Check - OIG/GSA screenings
  • complete the Affiliation Verification Form
  • Submit the EPIC login form

The instructor and the students will

  • sign Confidentiality Agreement
  • Complete the Minimum Necessary Form

Step 4:

The College Instructor will complete the Affiliation Verification form verifying that all the requirements have been met.

Step 5

College will submit (preferably 3 weeks in advance of placement)

The College will maintain the following student records in their files and be able to produce the record upon request from the hospital.

  • Background Check
  • Confidentiality Agreement
  • Copies of Licensures