Bachman Proximity Device Request Form 
The Bachman parking structure has security gates at each entrance. A student must go to the Bachman parking office on the 2nd floor of that structure, submit the form and receive their proximity chip in order to open the gate. The Bachman office will also be the site to purchase occasional use permits or daily permits for parking at Hillcrest. Thornton does not yet have gates; occasional use permits or daily permits can be purchased at the Thornton cafeteria.
Clinical Agency Evaluation Please have each student complete this evaluation before the end of their clinical rotation. Submit forms to the Nursing School Liaison on the 8th floor, room 804.
Computer Security Agreement Please have each student and faculty who need computer access complete this agreement ONLINE two weeks prior to assigned rotation. It is needed in order to allow Information Services to assign codes.
Confidentiality Agreement
Please have each student and faculty complete this agreement and submit to the Nursing School Liaison prior to assigned rotation.
Environment of Care (Safety) Instructions Learning Exchange Quick Tips on how to log into the Learning Management System along with link. Submit certificate of completion for all faculty and students prior to assigned rotation to the Nursing School Liaison. PLEASE PRINT INSTRUCTIONS BEFORE ENTERING LMS SITE.
Faculty Orientation Record All faculty must complete the faculty orientation record if they have not taught at UCSD before OR in the past year. Please complete and submit to the Nursing School Liaision prior to assigned rotation.
HIPAA Training To be kept on file at the nursing school.
MAK Class Sign In Sheet
MAK ID Badge Security Agreement Registry Student Nurse
MAK Student Nurse Resource Guide
MAK Student RN Competency
MAK Table of Contents Student Nurse Ref
MAK Training Eval
MAK Training Outline RN Instructor for RN Students
MAK WORK FLOWS
PCIS Assessments-VS-I and O Nursing Handbook
PCIS Care Plan- Student Nurse Handbook
PCIS Orders Overview- Student Nurse Handbook
Pyxis Access Request All students and faculty giving medications must complete this request prior to assigned rotation. Please ADD faculty name, school, all units for rotation and start/end dates to each form. Submit to the Nursing School Liaison.
Student / Faculty Process / Document Checklist Faculty must submit typed with all fields completed after MAK training (or student orientation day if not attending MAK training). Submit to the Nursing School Liaison.
Student Nurse Extern II Information Online
Student Orientation Day Sign-In Sheet Faculty to submit completed sheet with their student orientation day schedule prior to assigned rotation.
Student Orientation Record Faculty to complete this record for all primary clinical rotation groups and preceptorships. This form must be typed, completed in its entirety and 1.) Emailed WITHOUT social security numbers (SS#'s) and 2.) Faxed to (619) 543-7397 WITH SS#'s to the Nursing School Liaison. A total of 2 records are to be submitted. Do not e-mail SS#'s.