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Clinical Student Placement -Form of Learner Acknowledgement

Clinical Student Placement -Form of Learner Acknowledgement - Required Prior to Starting Placement

Form of Learner Acknowledgement is to be completed by the Learner (student or clinical instructor) prior to placement start date. 
1. Please provide the following so we can match your upload to your onboarding. 
2.

Please review and check off each item as you read.

If you object to any of them, you will be required to indicate this below, and your placement will be put on HOLD pending clarification with the Clinical Student Placement Coordinator. 

You will be required to sign at the end. 

In consideration of the opportunity to gain placement experience at the Hospital (SHN), I agree to comply with and be bound by the following terms and conditions: 
*This question is required.
3. Acceptance or Objection: *This question is required.
4. I attest that I have reviewed the above Acknowledgements prior to me starting my clinical placement at SHN.  *This question is required.
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