Healthy Community Forum
Student Orientation Checklist
(Clinical Groups)
Student Name: _________________________________ Date:_______________________
Instructor Name: ___________________________________________________________
Student Type:
 RN
 LVN
 OTHER______________________________
Semester:
 1ST
 2ND
 3RD
PLEASE CHECK:  ARC



 SCC
Hospital Information
 Mission, Vision and Values
 Standards of Excellence (sign and
return)
 Team Dynamics/Chain of
Command
 Compliance Training
 HIPAA
 Risk Management/Error Reporting
 Harassment in the Workplace
 Patient Rights
 Diversity & Cultural Sensitivity
 Interpreter Services
 Parking
 4TH
 OTHER__________
 CSUS
 OTHER ___________________
Department Specific Information
Role Expectations for Students
Unit/Department’s Role & Scope of Services
Access to Policies/Procedures via Intranet
Accident/Injury Reporting for Non-employees
Uniforms and Dress Code
GUEST RELATIONS
Key Words at Key Times
Special Role in Guest Relations
Environment of Care
 Infection Control
 Safety & Security
 Emergency Preparedness
 Lifesafety (Fire/ Evacuation)
 Medical Equipment
 Hazardous Materials and Wastes
I acknowledge that the items listed above were covered during the student orientation utilizing written
materials, videos and/or presentations. Attached is a list of students who participated in this student
orientation.
Instructor Signature:____________________________________________________________