APRN Application

Part 1: To Be Completed By Applicant (use one form for each requested clinical experience)

Are you fluent in Spanish? *
Are you a MetroHealth Registered Nurse? *

Part 2: I Would Like to Apply for the Following Semester and Year

Semester *

Part 4: Faculty Contact Information

The above-named is a student in good standing at this institution. Malpractice insurance covers the student away from this school. The student is authorized to participate in this clinical experience.

Your school will need to send a letter of verification of the following:

  • The student is an APRN student in good standing
  • The student possesses an unencumbered and current Registered Nurse License in the state of Ohio
  • Possesses a current BLS certification
  • Has a valid and clear background check on file at the school
  • Has appropriate malpractice and liability insurance
  • Has up to date vaccinations including TB and influenza vaccine (Nov-Apr)

Please have your school send a signed verification letter from the APRN program director attesting to all items above.