MultiCare Health Systems covers the following sites:
Allenmore Hospital, Good Samaritan Community Health Clinic/Hospital, Mary Bridge Children's Hospital and Health Center, Tacoma General Hospital
Deadline/Where to Return Paperwork (if Applicable)
At least 2 weeks prior to your clinical rotation.
Paperwork to Complete
Complete and return these forms to Kareena Andreas (see below).
• Student Immunizations
• Drug Screen - Multicare now requires a 5-panel urine drug screen for all students and faculty coming to Multicare. It needs to be done at a clinic/lab of your own choosing and at your own expense. Your insurance carrier may reimburse you for the cost. The school does not reimburse for it.
• MHS Information Services form (send to Kareena Andreas, not MHS IS) – need this one as soon as possible
I.S. User Registration Form
• MHS confidentiality / internet / needle stick form
Needle Stick Acknowledgement Form
• Do the EPIC online CBL (link below) & send exam
From student and preceptor
* MHS gratuitous agreement
Additional Student Site Requirements
- Bring copies of the following to your facility orientation:
- Most recent immunization record, including documentation of influenza vaccine (you can request these via firstname.lastname@example.org)
- CPR certification
- RN license
- Multicare no longer issues MHS ID badges. You need to wear your UW ID badge when working with them
- Complete HIPAA training
To access the CBL, go to:
user name: travelers
2. From there, select EPIC Essentials FastTrack
Contact the Site
The MultiCare Influenza Immunizations Policy requires employees and non-employed staff - which includes volunteers, agency staff, students, providers and vendor representatives -to either accept a vaccination, use flu mist (if available) or wear a mask when on the floor, unit or department where patients receive care or when within six feet of a patient for more than five minutes when outside of these areas.
By December 10, all employees and volunteers are responsible for either:
1. Accepting the vaccination and visibly wearing a black badge holder at all times, or
2. Complying with each of these requirements:
a. Complete the Influenza Vaccine eLearning module on MHSnet in the Learning Management System and complete a brief survey at the end of the eLearning module. Completion of both the eLearning module and the survey is acknowledgment of the 2012-2013 Declination Statement.
b. Wear a mask when on the floor, unit or department where patients receive care or when within six feet of a patient for more than five minutes when outside of these areas. The 2012 masking policy will go into effect on Monday, Dec. 10.
Non-employed staff such as vendors, contractors and non-employed providers are responsible for:
1. Providing evidence of having received the vaccine and wearing a black badge holder, or
2. Wearing a mask as outlined above.
If you have questions or would like more information, please visit the Influenza Updates page on MHSnet or contact Employee Health:
. MultiCare Employee Health: employee.health-Tacoma@multicare.org or 253.403.1007.
. Good Samaritan Employee Health: employee.health-Puyallup@multicare.org or 253.697.1560.
The School of Nursing Will Provide to the Site:
Student Background screen & background release (to include: SS# Trace, Washington State Patrol WATCH, County & Federal criminal record, Global Watch Alert, Sex Offender registry, FACIS)