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It confirms consent for release of educational, health, and background records to agencies and for disclosure of social security information for licensure and clinical placement. It addresses approval of required documentation, mandatory orientation, consequences for cheating or plagiarism, HIPAA confidentiality protections, exposure to infectious risks, accommodation disclosure, and health insurance obligations, including the possibility of dismissal or clinical exclusion for unmet requirements.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/student-handbook-guidelines-verification-form/459557/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/student-handbook-guidelines-verification-form/459557.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What does the Guidelines Verification Form require students to confirm?","Question",{"text":113,"@type":114},"Students must acknowledge they have read the School of Nursing Student Handbook in full and agree to the listed statements, including responsibilities and program requirements.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What records may be released, and for what purposes?",{"text":118,"@type":114},"Students agree to release educational, health, and background records to professional/health care agencies and other designated agencies with a legitimate interest. Students also agree to release their social security number to the Florida Board of Nursing for licensure and clinical facilities for clinical placement.",{"name":120,"@type":111,"acceptedAnswer":121},"How does the form describe consequences for not meeting documentation or conduct requirements?",{"text":122,"@type":114},"Students may not participate until required documentation is submitted and approved, orientation absences may lead to withdrawal, and students found guilty of cheating and/or plagiarism may receive an “F” and/or be dismissed. Missing health insurance or required health documentation can prevent clinical attendance and lead to clinical failure and/or dismissal.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},459557,1791357737,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","Student Handbook  \n2026-2027  \nIRSC is an EA/EO educational institution.  \nIndian River State College  \nSchool of Nursing  \nStudent Handbook Guidelines Verification Form  \nThis is an acknowledgment form confirming each student has read the School of Nursing Student Handbook in its entirety and agrees to the following statements:  \nI agree to have my educational, health, and background records released to professional/health care agencies requesting that information, and other agencies as designated by IRSC who have a legitimate interest in my student records.  \nI agree to have my social security number released to the Florida Board of Nursing for application for licensure and clinical facilities for clinical placement.  \nI understand that I may not participate in any nursing program until I have submitted and received approval of all required documentation to the School of Nursing (e.g., annual physical, immunizations, CPR, drug screen, background check, and health insurance [Nursing Assistant students are exempt from health insurance submission]) . This information must be kept up-to-date, or I can be withdrawn from the program.  \nI understand that orientation to courses and clinical facilities is mandatory. Absence for any reason may result in my being withdrawn from the course. I understand that clinical placement may be anywhere in the four-county area.  \nI understand changes may be made to the School of Nursing or College guidelines at any time. Should a change occur, students will be notified verbally and in writing as to what the change entails and the date it will take effect. Students will receive an electronic copy of the changed guidelines to keep for their records.  \nI understand any student found guilty of cheating and/or plagiarism may receive an “F” in the course and/or be dismissed from the program.  \nI agree to have information regarding my attendance and performance released for financial aid purposes.  \nI understand that information disclosed to me from the client’s medical record is private and protected by state and federal law (HIPAA confidentiality) . State law prohibits me from making any disclosure of medical information without the specific written consent of the person to whom such information pertains, or as otherwise permitted by federal, state, or local law.  \nI understand that I may be exposed to bloodborne pathogens and/or potentially infectious diseases during my clinical rotations. I understand this can further impact exposure risk if I have any change in health status, such as immunosuppression issues or pregnancy. If I request an accommodation, I must disclose my change in health status to the course coordinator and the School of Nursing.  \nI understand that I must have personal health insurance [PN and ADN only], and the policy must be active for the entire time I am enrolled. Failure to have personal health insurance while enrolled in a nursing clinical course will result in my inability to attend clinical, course failure, and/or dismissal from the School of Nursing. I will submit a copy of my current insurance card/policy at the beginning of each semester. Should my health insurance lapse, I will report it to the School of Nursing within 24 hours.  \nI understand health care facilities reserve the right to change health and background requirements at any time, and/or deny a student clinical placement. All required health documentation is required for clinical. Students who are unable to receive the flu vaccination will not be eligible for clinical placement. Inability to attend clinical may result in clinical failure and possible dismissal from the program.  \nI give the College permission to use my photograph in social media posts by the School of Nursing to promote nursing programs and increase student engagement.  \nBy signing this document, I acknowledge that I have read the IRSC Student Handbook and my specific program section. I agree to comply with all terms and conditions. Students u","cbCaisY7LahU3LYX","https://ap.wps.com/l/cbCaisY7LahU3LYX","pdf",2881739,81,"English","# Student Acknowledgement and Consent\n## Records Release and Licensure/Placement\n## Required Documentation, Orientation, and Attendance\n## Confidentiality, Misconduct, and Program Consequences\n## Clinical Exposure, Accommodations, and Health Insurance\n## Nursing Division Social Media Permission","[{\"question\":\"What does the Guidelines Verification Form require students to confirm?\",\"answer\":\"Students must acknowledge they have read the School of Nursing Student Handbook in full and agree to the listed statements, including responsibilities and program requirements.\"},{\"question\":\"What records may be released, and for what purposes?\",\"answer\":\"Students agree to release educational, health, and background records to professional/health care agencies and other designated agencies with a legitimate interest. Students also agree to release their social security number to the Florida Board of Nursing for licensure and clinical facilities for clinical placement.\"},{\"question\":\"How does the form describe consequences for not meeting documentation or conduct requirements?\",\"answer\":\"Students may not participate until required documentation is submitted and approved, orientation absences may lead to withdrawal, and students found guilty of cheating and/or plagiarism may receive an “F” and/or be dismissed. Missing health insurance or required health documentation can prevent clinical attendance and lead to clinical failure and/or dismissal.\"}]","Student Handbook - Guidelines Verification Form | PDF",1790756236,204]