Associate Degree Nursing (RN)
 Clinical Requirements Packet - Wait List Students Only

Congratulations!  By now you have been informed by the Health Sciences Office that you have been accepted to the class of Fall 2018 and need to submit all of the clinical requirements. Hopefully, you have completed your immunizations based on previous communications and deadlines as some immunizations (Hepatitis B) take as much as 4 - 6 months to complete the required series. All documentation for the Clinical Requirements (immunizations, CPR, etc.) must be submitted as a complete packet in a large envelope by

Part 1 - Monday, April 30, 2018
Part 2 - Friday, June 15, 2018

Records will not be accepted separately.

Pre-Enrollment Clinical Requirements checklist is available for you to print and use as a guide in completing all of the processes necessary. If you have been accepted into the class, complete all Steps (A - G) following the directions here, on the checklist and in the associated policies.

If you have been selected as an alternate to the class, proceed with Steps A - D and then STOP until directed by the Health Sciences Division. The last steps of the process are time-sensitive and should be completed only when you have been accepted into the class.

We encourage you to start the process by reviewing the clinical requirements for the program and the required immunizations along with the associated clinical requirements policy.

Step A - Immunizations - Document on the Clinical Requirements Checklist and the 2-Step TB Screening Questionnaire. You will need to provide documentation of your immunizations and/or titers and your 2-step TB tests.

Step B - CPR Certificate - As a nursing student, you will be assigned to patients in healthcare facilities for your clinical experiences and as such are required to be currently certified in Basic Life Support with CPR for adults, children, and infants and tested with two-person rescue. To document current CPR certification, submit a copy of your CPR card in your packet.  

Step C - Technical Standards - Nursing is a physically demanding profession and you must be prepared to meet the technical standards necessary to physically perform the functions of nursing. Upon review of the standards, print the Technical Standards form​, initialing each of the areas in which compliance with the standard is possible.  Then sign and date as indicated on the bottom of the form.

Step D - Confidential Clinical Application - The initial step to completing the criminal background check is to complete the Health Science Program Application for Clinical Practice form. This form discloses to Shasta College (Confidentially) the existence of any criminal issues. While the existence of convictions will not necessarily disqualify you from enrollment, failure to disclose may be considered falsification and will result in the offer of enrollment being rescinded and will be grounds for immediate termination upon discovery at any time during enrollment.

Step E - Physical Examination - The required physical examination must be completed within no more than 6 months prior to entering the program. The results of the physical examination must be documented on the Health Data/Physical Exam form. The front page of the Health Data form is to be completed by you and the back page by your healthcare provider. 

Step F - TB Screening - The TB screening results will be documented on the Immunizations Form and on the 2-Step TB Screening & Questionnaire form. If you have had a past positive PPD, please document on the Confidential TB Screening & Questionnaire form and submit with appropriate documentation.

Step G - Criminal Background Check/Drug Screening -  It is important for you to follow the Step-By-Step Instructions for completing the Criminal Background Check and Drug Screening. Proceed with this step ONLY when notified of your acceptance into the class.

Once you have completed the Clinical Requirements and have the required documentation for each item necessary, the packet may be submitted to the Health Sciences office. Health Sciences office staff will review the materials and verify completion. All materials submitted become the property of Shasta College and will not be returned to you. We encourage you to make copies of all the forms and materials submitted for your own records.

Your Program Mandatory Orientation will consist of two parts: 
          (Dates, times and location as appropriate are included in your Enrollment Invitation Email)

  • Program & Systems Orientation will be provided to you via our online learning management system (CANVAS).  You will be given a 2-week period of time in which to the complete the orientation. 
  • Faculty & Class Introduction will be a physical face-to-face meeting at the Health Sciences building to meet your faculty and review the Class guidelines.  

Completion of both parts of the Mandatory Orientation is required to complete your eligibility and be given authorization to register for the Fall 2016 semester.     

 Confirm your attendance at Mandatory Orientation Class Introduction HERE    

To prepare for the enrollment, you will need to read the ADN Student Handbook​ and complete the forms associated.  The forms will need to be printed out, signed and submitted​ with your Pre-Enrollment Clinical Requirements Packet.

These links contain all of the forms you will need to complete your Clinical Requirements:


Part 1 - Pre-Enrollment Clinical Requirements Checklist​

Part 2 - Pre-Enrollment Clincal Requirements Checklist​

Clinical Requirements Policy

Criminal Background Check & Drug Screening Instructions

Pre-Enrollment Criminal Background and Drug Screening Policy

Drug Screening, Criminal Background and Criminal Convictions Policy - Enrolled Students 

Clinical Requirements Checklist

2-Step Process Tuberculosis Screening & Questionnaire Form   

Confidential TB Screening & Questionnaire Form

Technical Standards Disclosure Form

Health Science Program CONFIDENTIAL Application for Clinical Practice

Health Data Form/Physical Examination  

If at any time during the process of preparing for enrollment, you make any changes to your contact information, please notify us immediately.


Technical Standards

Health & Safety Clinical Requirements​

  Contact Information Change Form  

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