Read this section pertaining to DVH Mandatory Signature Required Documents (MSRD) carefully.
Download, print, sign and return the required documents to the nursing office no later than: July 20, 2017.
Any documents that are not completed and in black ink will be returned to you, and may delay your clinical rotation hours.
See list below to print-out: (listed on “Read Me” page)
- Mandatory Signature Required Documents must be printed as follows:
- New Student/Contractor Venue/Volunteer Checklist
- Abuse Reporting Statement
- Consent to Obtain Consumer Reports For Employment Purposes
- Compliance Program and Code of Conduct – Employee/Volunteer/Medical Staff Member Acknowledgement Form (1 of 3).
- Compliance Program and Code of Conduct – Independent Contractor Acknowledgement Form (2 of 3).
- Compliance Program – Members of the Board of Directors/Governing Boards (3 of 3).
- Confidentiality Policy/HIPPA Acknowledgement
- Emergency Contact Information
- Information Security Agreement – (1 of 2)
- IT System Access Request Form – (2 of 2)
If you have any questions, please email: Deanna Sherrick Clinical Coordinator @ Deanna.Sherrick@vvc.edu