RN-BSN Pre-Clinical Requirement Checklist
Please review your paperwork carefully; only completed packages will be accepted.
Scanned documents may be submitted by email to: smith_christopher1@columbustate.edu
or faxed to: (706)507-8565.
ANY EXCEPTION TO SUBMITTING A COMPLETED PACKAGE OF PRE-CLINICAL PAPERWORK
MUST BE APPROVED BY THE RN-BSN, PROGRAM DIRECTOR, PROFESSOR HAWKINS.
Please submit an exception request to the RN-BSN nursing advisor, Mrs. Warden by email.
warden_joanne@columbusstate.edu and copy Mr. Smith.
PLEASE SUBMIT TO MR. SMITH, PROOF OF: smith_christopher1@columbusstate.edu
☐ Liability Insurance.
☐Completed physical evaluation and medical history forms.
☐ Health Insurance or notarized waiver of health insurance. (Available at advisor’s office).
☐ Two MMR immunizations or positive MMR titer.
☐ Hepatitis B vaccine series or positive Heb B titer. (Or proof of series started).
☐ Chicken Pox vaccinations or positive vzv titer.
☐ TDAP (tetanus/diphtheria/pertussis) vaccination.
☐ Annual ppd (tuberculin skin test). Positive result requires a chest x-ray report.
☐CPR card (must be AHA-approved BLS course). Copy of front and signed back required.
☐Copy of GA Registered Nurse license __________________________
RN School was NLNAC accredited YES ___ NO ___ date graduated _____
☐Background Check/Drug Screen. (Forms available at advisor’s office or may be mailed)