Practicum 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 *
What degree are you pursuing? *

Have you identified a MetroHealth preceptor? *

Part 4: Faculty Contact Information

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

  • The student is 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 (BCI/FBI within 1 year)
  • Has up to date vaccinations including TB, COVID-19 vaccine, and influenza vaccine (Oct-Apr)
  • *Clean and current 10-panel drug screen within 1 year
*MetroHealth employees are exempt from asterisk points

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