Download Clinical/Practicum Compliance Requirements Couple and Family Therapy Program Continuing Annual Recheck Requirements

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 Clinical/Practicum Compliance Requirements
Couple and Family Therapy Program
Continuing Annual Recheck Requirements
Please use this form as a guide for remaining in compliance with all clinical guidelines through your time in the program.
You may print this checklist and use it as a guide throughout the compliance process.
ITEM
DATE COMPLETED
Screenings:
FBI Fingerprint
State Criminal Background Check
Child Abuse Clearance
Drug Screen
Check for yearly update reminders on the following:
Annual One-Step PPD
Current Tdap (must be within last 10 years)
Safety and Health Online Training
Check your individual due date;
must be current while in clinical
course work
CPR Certification: Must be the American Heart Association OR the American Red Cross
– (CPR/AED for the Professional Rescuer OR BLS for the Healthcare Provider). Must be
current. The renewal date will be set according to the expiration date of your certification.)
Emergency Contact Form
(Check if information is current – only needs to be updated if information has changed.)
Seasonal Influenza Form
(Documentation must be submitted by October 1st annually. This must be on file for all Fall,
Winter and Spring clinical/practicum rotations.)
UpdatedSR6734/20/2016 Page1of1