Skip to content
McLaren Health Care
Main Menu
Services
Find a Physician
Hospitals & Locations
Patients & Visitors
About McLaren
COVID-19
Careers
ER Visit
Book an Appointment
Pay Bill
Medical Records
Search
Doctors
Locations
Back to Top
Schedule
Pay Bill
McLaren - Hospitals in Michigan and Ohio
|
Application for Osteopathic Elective Clerkship - Section II
M
c
Laren Health Care
Application for Osteopathic Elective Clerkship - Section II
Application for Osteopathic Elective Clerkship - Section II menu
Application for Osteopathic Elective Clerkship - Section II
Award Winning Care
Community Health Needs Assessment and Implementation Plans
Contact Us
History
Diversity and Inclusion
Military Veterans
Executive Diversity Council
Diversity and Inclusion In Action
LGBTQ+ Health
LGBTQ+ Health - McLaren Port Huron
Training and Resources
McLaren Health Care Executive Team
Leadership Podcast
Video Vault
Our Foundations
Fundraising Opt-Out
Research & Clinical Trials
The Doctor Is In
Application for Osteopatic Elective Clerkship - Section II
McLaren Greater Lansing Application for Osteopathic Elective Clerkship - Section II
* Indicates required information
This is a secure site. Please complete the information below.
Please Provide the following information on -
(last, first, middle initial)
:
*
The above named student is a student in good standing:
Yes
No
Comments:
They are approved to take the requested elective(s):
Yes
No
Comments:
They will be covered by liability insurance while rotating at McLaren Greater Lansing:
Yes
No
Comments:
Our records show this student has:
Personal health coverage which will be in effect during this protation:
Yes
No
Comments:
Completed required OSHA training in Universal Precautions within 12 month period proceding this elective:
Yes
No
Comments:
Had all recommended immunizations:
Yes
No
Comments:
Had a negative PPD skin test within the preceding 12 months:
Yes
No
Comments:
Had a serology test showing immunity to rubella:
Yes
No
Comments:
Received the hepatitis B vaccine series:
Yes
No
Comments:
Had a physician documented case of variecella OR has had a serolgy test showing immunity to varicella:
Yes
No
Comments:
Comments:
Submit any other documents and a copy of the students immunization records to:
McLaren Greater Lansing
Medical Education
Attn: Gary Riley
401 W. Greenlawn Ave.
Lansing, MI 48910
Student Affairs Dean or Official (name and title):
Phone Number:
Email:
I agree that the above is true to the best of my knowledge, initial here:
*
Page Loading
Loading...