Student Services Credentialing Packet Information

Students that are assigned to a preceptor associated with Clark Regional Medical Center are to complete the Clark Regional Medical Center packet. Required documentation to be turned in 2 weeks prior to rotation start date:

• Immunization records
• TB Skin-test
• Copy of driver’s license
• Drug-screen
• Completed background check (less than one year old)
• Flu Vaccine (October-March)
• Updated COVID vaccine series card
• Verficiation letter for PPE training for donning and doffing
• Completed Code of Conduct (PDF)
• Review student orientation (PDF)
• Complete Student Orientation Signature Sheet (PDF)
• Complete Security Access Request Form (PDF)
• Complete Request to Resume Educational Rotation form (JPG)

Credentialing contact for Clark Regional Medical Center: Tracy Copher

Students that are assigned to a preceptor associated with Fleming County Hospital are to complete the Fleming County Hospital packet. Required documentation to be turned in two weeks prior to rotation start date:

• Letter of good standing from current institution
• Copy of liability insurance
• Immunization records
• TB Skin-test
• Copy of driver’s license
• Completed background check (less than one year old)
• Updated COVID vaccine series card
• Completed Fleming County Hospital Student Packet (PDF)

Download the Fleming County Hospital Confidentiality Statement (PDF).
Download the Graduate Medical Education Policy (PDF).

Credentialing Contact for Fleming County: Kyle Carter

Students that are assigned to a preceptor associated with UK King's Daughters are to complete the following orientation materials. Required documentation to be turned in two weeks prior to rotation start date:

• Signed Exhibits A, B, and C from the Student Handbook (PDF)
• Completed student post-test (PDF)
• Review General Compliance Module (PDF) and return completed and signed Attestation Form (PDF)
• Review COVID Education (PDF) and return completed and signed COVID Attestation Form (PDF)
• Complete TB Risk Assessment Form (PDF) (Student may complete)
• Immunization Requirements per OCC Med:
  • A. Proof of 2 step TB Skin Test or proof of three consecutive years or proof of Blood Assay Mycobacterium
  • B. Proof of Influenza vaccination during Flu Season or copy of Declination Form
• Updated COVID vaccine series card
• Please send a student picture electronically (must be on a KY blue background and no PDF's) to forward to HR to make a student ID badge. If you do cannot send a picture, you will need to make an appointment with HR to have the badge made prior to starting your rotation.

Students that are assigned to a preceptor associated with KDMC are to contact Matt Greathouse for credentialing questions or information.

Students that are assigned to a preceptor associated with the Meadowview Regional are to complete the Meadowview Regional Student Packet. Required documentation to be turned in 2 weeks prior to rotation start date:

• Letter of good standing from current institution
• Copy of liability insurance
• Immunization records
• TB Skin-test
• Copy of driver’s license
• Completed Confidentiality and Security Statement
• Completed Common Ground Code of Conduct
• Completed HIPAA-Patient Privacy Program
• Completed Student SAF Information
• Background Check
• Drug Screen
• Updated COVID vaccine series card

Credentialing Contact for Meadowview Regional Medical Center: Jessica Darnell 

Students that are assigned to a preceptor associated with ARH Hospital are to contact Amber Cole, Administrative Assistant or Stephanie Owens, Regional HR Officer. Required documentation to be turned in 2 weeks prior to rotation start date:

• Letter of good standing from current institution
• Copy of liability insurance
• Immunization records
• TB Skin-test
• Copy of driver’s license
• Completed background check (less than one year old)
• AHEC Student/Resident Fact Sheet

Students that are assigned to a preceptor associated with UK St. Claire are to complete the UK St. Claire packet below. Required documentation to be turned in 2 weeks prior to rotation start date:

Orientation Overview (PDF) must be reviewed prior to your arrival.

Students must submit  the following:

• A letter from the institution stating the student is in good standing

• Criminal/Caregiver background check completed and does not have any past history of drug abuse, felony, etc

• Drug screen completed and is negative

• Immunization and health records (2 MMR's) are compliant with CDC recommendations

• TB skin tests are compliant with CDC recommendations (1-3 weeks apart within the last year or three consecutive yearly tests or a negative Quantiferon Gold Blood test). 

• Provide copy of current vaccine for the current flu season of October - March. 

• Provide COVID vaccine card if you have received vaccines between 2023-present only.

Complete one of the following:

• UK St. Claire Credentialing Packet for Students
• UK St. Claire Credentialing Packet for Residents
• UK St. Claire Credentialing Packet for Nursing Students
• UK St. Claire Credentialing Packet for Nursing Instructors 
• UK St. Claire Credentialing Packet for Nurse Practitioner Students

*If you are completing a psychology rotation, please read the following orientation PDF and sign the clinical agreement document:

• Orientation (PDF)
• Clinical Agreement (PDF)

Credentialing contacts for UK St. Claire are Jessica Pennington and Sue Russell.
Credentialing contact for letter of good standing for UK St. Claire is Jessica Pennington, Student Services Coordinator.

Students that are assigned to a preceptor associated with St. Joseph Mt. Sterling Hospital are to complete the St. Joseph’s Student Packet. Required documentation to be turned in 2 weeks prior to rotation start date:

• Letter of good standing from current institution
• Copy of liability insurance
• Immunization records
• TB Skin-test
• Copy of driver’s license
• Completed St. Joseph’s Student Packet (PDF)
• Provide copy of Covid 19 vaccine card (if applicable)

Download Ethics at Work Reference Guide (PDF).

Credentialing Contact for St. Joseph’s Hospital: Shell Todd at shell.todd@commonspirit.org

Students that are assigned to a preceptor associated with Sterling Health Care are also to complete the St. Joseph’s Student Packet. Required documentation to be turned in 2 weeks prior to rotation start date.

• Immunization records
• TB Skin-test
• Copy of driver’s license
• Drug-screen
• Completed background check (less than one year old)
• Flu Vaccine (October-March)
• Bloodborne Pathogens Fact Sheet 
• HIPAA Fact sheet 
• Student Policy 
• Updated COVID vaccine series card

Credentialing contact for Sterling Health: Jennifer Carpenter