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    Clinical Clearance 1

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    estampadorlucyl20
    The document is a student clearance form from a nursing department listing hospitals, rotations, instructor signatures, and approvals from administrators.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Clinical Clearance 1

    Uploaded by

    estampadorlucyl20
    3 views1 page
    The document is a student clearance form from a nursing department listing hospitals, rotations, instructor signatures, and approvals from administrators.

    Original Description:

    Lecture notes

    Original Title

    Clinical-Clearance-1

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    © © All Rights Reserved

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    The document is a student clearance form from a nursing department listing hospitals, rotations, instructor signatures, and approvals from administrators.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views1 page

    Clinical Clearance 1

    Uploaded by

    estampadorlucyl20
    The document is a student clearance form from a nursing department listing hospitals, rotations, instructor signatures, and approvals from administrators.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    College of Allied Health Science

    Nursing Department

    Student’s Clearance Form (RLE)


    Name of Student:___________________________________________

    Years & Section:__________________ ID Number:_________________ Academic Year: _______________

    Hospital/Agency Rotation/Date of Exposure Instructor’s Name & Signature REMARKS


    _________________ ______________________ __________________________ _____________
    _________________ ______________________ __________________________ _____________
    _________________ ______________________ __________________________ _____________
    _________________ ______________________ __________________________ _____________
    _________________ ______________________ __________________________ _____________

    Noted by:_____________________________________
    Marie Joyce J. Simpas, RN, MAN
    Clinical Coordinator – Level 3

    Approved:____________________________________
    John Rey S. Olpoc, RN, MN
    Dean

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