Updated 26th April 2011

SCHOOL OF NURSING, MIDWIFERY AND HEALTH SYSTEMS, CLINICAL ALLOCATIONS OFFICE

Notification to International Exchange Students of Mandatory pre-clinical placement requirements

Student’s Name / ______
UCD Student Registration Number / ______
Name of ParentUniversity / ______

In order to undertake a placement in a clinical area during an exchange programme, a student must submit all of the following to the Clinical Allocations Office. All documents must be submitted four weeks prior to the commencement date of the clinical placement. This evidence is required in order to ensure that risks to both students and patients are minimised.

For office-use only / For office-use only
Health Screening and Vaccinations: Records Required / Evidence received
(please tick) / Evidence received
(Signature of staff member receiving the document
and date of receipt)
Yes / No
1. / Written evidence of having had 3 doses of Hepatitis B Vaccination
2. / Written evidence of having had a blood test after completing the Hepatitis B Vaccination programme to show immunity to Hepatitis B
3. / Written evidence of having had 2 doses of vaccination for
  • Measles,
  • Mumps
  • Rubella
if your Date of Birth is during 1978 or after 1978
or
Written evidence of having had a blood test showing immunity to
  • Measles
  • Mumps
  • Rubella
If your date of Birth is prior to 1978
4. / Written evidence of having had a blood test showing immunity to Varicella.
5. / Either:
Written evidence of the presence of a BCG Scar
or
Written evidence of having had BCG Vaccine
or
Written evidence of having had a positive Mantoux test
(one of the above three must be submitted)
For office-use only / For office-use only
Other Essential Requirements / Evidence received
(please tick) / Evidence received
(Signature of staff member receiving the document
and date of receipt)
Yes / No
1. / A certificate of the insurance normally provided by your university during all of your clinical placements.
2. / An original copy of a police force clearance, which has been officially stamped and dated, and has been obtained no longer than one year before the start date of the placement.
3. / Written evidence of having undertaken a Moving and Handling training programme
4. / Written evidence of having undertaken a Basic Life Support training programme
5. / A photocopy of a current UCD student card (as evidence of registration).
Date instructions are issued / __/ __/ ____
Issued by (staff member’s signature) / ______
ALL exchange students must provide their own uniform for the clinical placement period

---oOo---