HMC Online Student Orientation
Student Site Coordinator’s Checklist
Your new student should have completed the HMC New Student Orientation. Use this checklist to confirm their submission and/or
completion of the required quizzes and forms. Remember to provide your signature and date at the bottom of the “Privacy,
Confidentiality and Information Security Agreement” form. During your departmental orientation, review the quiz answer sheets
with your student to ensure they understand the items that they answered incorrectly.
Place documents in the Department Student Records file. Completion and correct filing of these orientation documents will meet the
requirements of our regulatory agencies.
Student Name: _________________________________ Date Submitted: ______________________________________________

Document

Completed Quiz Results for each module printed by student after
completion of online training
□ Module 1: Ethics and Compliance
□ Module 2: Environment of Care
□ Module 3: Infection Control
□ Module 4: Organizational Improvement
□ Module 5: Patient Safety
□ Module 6: Promoting a Respectful Workplace
Page 31 of Integrity at Work (IAW) Booklet


Privacy, Confidentiality and Information Security Agreement
(PCAISA) – given to you by student (downloaded from website).
If you have any Corporate Compliance questions, please contact
the HMC Compliance Department at 206-744-9065.

Patient Rights and Responsibilities signature page.
If You Don’t Have It
Students print confirmation
page from quiz link.
Site Coordinators can
access quiz results within
their catalyst tools (see Site
Coordinator’s Resources).
It is located on the
“Trainings: readings,
quizzes and forms” section
of the website.
It is located on the
“Trainings: readings,
quizzes and forms” section
of the website.
It is located on the
“Trainings: readings,
quizzes and forms” section
of the website.
What To Do
Using quiz results - review any incorrect
answers with the student so that there is
an understanding of the missed
answers.
Keep in Department Student File.
Verify student signature. Keep
original document in Department
Student File.
Signature is required by the
appropriate HMC designee
(e.g. coordinator or supervisor).
Provide copy to student and keep
original in Department Student File.
Verify student signature. Keep original
document in Department Student File.
Additional training and records retained in Department Student file.
 UW Medicine HIPAA completion records
 Immunization record:
o Current immunizations against diphtheria, tetanus, measles (rubeola), mumps, rubella (or a positive rubella titer), and hepatitis B
o Tuberculosis Skin Test (PPD test) within one year
 Criminal background check
o Any criminal charges or convictions (even if they are not violations of the Child and Adult Abuse Law) must be disclosed to the
student’s instructor, who will receive permission from Harborview on the student’s behalf before she or he may begin the Harborview
student assignment.
For questions contact: Organizational Development and Training
odtreg@u.washington.edu, Box 359422
Updated June 2010