Linfield-Good Samaritan School of Nursing
Health Passport Requirements – Spring 2016, Due Jan 1, 2016.
For students to be eligible for participation in laboratory and clinical rotations throughout the
program each individual is responsible for satisfying and maintaining compliance to the Health
Passport Requirements by the deadline stipulated in your admission materials. Non-compliance of
Health Passport Requirements will exclude students from their cohort and/or from the Integrated
Experiential Learning (IEL) course.
Each student is required to manage a Certified Profile Account (background check, drug screen,
medical document manager). To enroll, place an order at www.CertifiedBackground.com using
package code if78. To maintain IEL lab and clinical eligibility, each student is responsible to ensure
that all requirements are compliant and will not lapse during the semester as either overdue or
rejected.
Upload official documents to your Certified Profile Account for each requirement. Lab reports,
clinical records, employee records, school records, state alert system reports, immunization cards
(with date, provider’s signature, initials or stamp included), or provider letters are all acceptable.
SECTION I - VACCINES
Item 1. Tuberculosis Screening: do these tests first *
Take the two step TB skin test. This means two separate tests taken 1-3 weeks apart.
Upload results for both tests together.
If you prefer, you may take an IGRA blood test, Quantiferon Gold or T-Spot test.
Chest X-ray is an option if either the tests above come up positive but you must complete a
Review of Symptoms form annually thereafter.
*Note – TB skin testing is affected by other vaccines. Complete this item first.
Item 2. Hep B
Many students have had the series of three vaccines already. If you have those
records to upload, then only a positive Titer (blood test) is needed.
If your titer is negative or if you have no records, then three vaccinations are required as
follows: #1, #2 (one month after first), #3 (five months after second); and these must be
followed by a titer (blood test) for Hep B Surface Antibody (four to six weeks after the third
shot).
Item 3. Measles, Mumps, Rubella
Many students have had these two vaccines already. Please upload these records.
If you have no record of vaccinations for MMR, you may take the two-shot sequence for
MMR; the second is due no earlier than one month after the first one.
BE SURE YOUR TWO TB SKIN TESTS ARE COMPLETED BEFORE
RECEIVING AN IMMUNIZATION.
Item 3. Measles, Mumps, Rubella, continued:
If you prefer to not get a second series, you may instead get individual positive titers (blood
tests) for Measles (Rubeola) and Mumps and Rubella. If the titer is negative, you will need to
proceed with getting the two immunizations.
Item 4. Varicella (Chicken Pox)
Same instructions as MMR.
Item 5. Tetanus, Diptheria, Pertussis (TDaP)
Upload documentation of this vaccine within the past 9 years. Otherwise the vaccine is
required.
Item 6. Annual Flu Shot (Fall and Spring cohorts only):
The Fall flu shot is valid if received after Sep 1 of the current Flu Season.
SECTION II – PAPERWORK
The following items must be completed by the student:
1.
2.
3.
4.
Essential Functions Form
Health Assessment Form (pages 1 and 2)
Proof of Health Insurance
BLS for Healthcare Providers certificate of completion or Card.
This MUST be the American Heart Association BLS for Healthcare Providers training.
The following must be completed by your healthcare provider:
1. Health Assessment Form (page 3): upload all three pages together (see Checklist)