The forms for your clinical courses are provided below. You will need the Adobe Acrobat Reader (free document viewing software) to see the forms. If you cannot view the forms, click the image below labeled 'Get Acrobat Reader' and save the Acrobat Reader installation file to your computer. Once it is saved, double click the file to install it. If you have any questions or concerns, contact Nursing Learning Resource Center at nursingLRC@bsu.edu
Sim Confidentiality Photo Form
Informed Consent Baccalaureate Form
Informed Consent RN to BS Form
Informed Consent Masters Form
HIPAA form
Standard Precautions form
Hepatitus Waiver
RN to BS Track Checklist
NUR 405 Students
Disclosure of Criminal Background
Pre-Course and Clinical Information
· Nursing 610
· Nursing 611
· Nursing 614 Additional Information
· Nursing 672 Administrator
· Nursing 672 Educator
· Nursing Graduate Pins
· 1. Agency Agreement
· 2. Clinical Preceptor Information
· 3. Agency Evaluation NP Track
· 3B. Agency Evaluation Edu/Admin Track
· 4. Clinical Information Nursing 610 611 614
· 5. Preceptor Evaluation for NUR 610, 611, 614
· 6. Preceptor Information for Concepts Courses
· 7a. Clinical Information Nursing 680
· 7b. Clinical Information Nursing 682
· 7c. Clinical Information Nursing 684
· 7d. Clinical Information Nursing 672 (NP)
· 8. Preceptor Evaluation Nursing 680 682 684 672 (NP)
· 9. Student Self-Evaluation Nursing 680 682 684 672 (NP)
· 10. Faculty Evaluation Nursing 680 682 684 672 (NP)
· 11. Clinical Faculty Information Form
· 12. Clinical Timesheet
· 13. Patient Contact Log
· 14. Clinical Information Checklist
· 15. Clinical Information Nursing 634
· 16. Preceptor Clinical Evaluation Nursing 634
· 17. Student Self-Evaluation Nursing 634
· 18. Physical Assessment Evaluation Forms 634
· 19. Final Comprehensive Physical Exam 634
· 20. Clinical Information 672 Administrator
· 21. Student Self-Evaluation 672 Administrator/Clinical
· 22. Classroom Evaluation 672 Educator
· 23. Clinical Evaluation 672 Educator
· 24. Clinical Evaluation 672 Administrator/Clinical
· 25. Preceptor/Clinical Faculty Information 672 Educator
· 26. Agency Evaluation by Student NUR 303
· 27. Patient Contact Log NUR 303
· 28. Preceptor Clinical Evaluation Form NUR 303
· 29. Student Self-Evaluation Form NUR 303
· 30. Clinical Preceptor Information 303, 401, 404, 405
· 31. Clinical Information Checklist (RN to BS Program)
· 32. Care Plan
· 33. RN Clinical Evaluation
· 34. Clinical Information for Nursing 303, 401, 404, 405
· 35. Pediatric Rehabilitation Clinical Experience Form
· 36. Clinical Evaluation 404
Printing the Forms
To print the forms, click the print button on the Adobe Acrobat screen as shown below...