Clinical Placements Northwest
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Orientation
Training
Clinicals
Orientation, Training and Clinicals will require sign-in.
Health and Safety Requirement
Requirement Name
Action
Accept
Decline
Waiver
Temporary
completed
Renews
Submitted Documentation
Doc 1
Doc 2
Doc 3
Date Uploaded
Declination/Waiver Request
Medical
Allergy
Religious
Other
Comments
Description
Flu Vaccination Data Collection
Vaccination Date
Provider Type
Member
Private
Provider Information
Member Facility ID
Provider Name
this could be window where uploaded documentation appears
Reviewer will be recorded in db based on user signed in
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