Health Sciences Center

Prisma Health Student Enrollment

This form should only be submitted by students that have received the Principal Investigators' or Faculty's approval to participate in the research experience.

CLEARANCE TYPE

***** You've indicated you will not be on a Prisma Health property, that you will not be in contact with patients and that you would not need access to patient or hospital related data. Please confirm with your Prisma Health host that you need to be cleared through Prisma Student Affairs. *****

STUDENT INFORMATION

Please enter the email address that you previously used to log into myClinicalExchange. Using the email address associated with your myClinicalExchange account allows your previously submitted clearance documentation to cascade. This includes your background check and immunization records.

Enter Email
Confirm Email
Your Date of Birth and the last 5 digits of your Social Security Number are required by Prisma IS. Prisma IS will need these in order to assign any technology related request submitted by your Prisma host.
MM/DD/YY

PRISMA HEALTH DEPARTMENT INFORMATION

There are approximately 1500 Prisma Health locations to select from. If you're uncertain of the Facility, Department and Unit, please use the Search feature below. After searching and identifying the correct Facility, Department and Unit, please transfer this information in the corresponding fields below.


Examples include: Peds Rheumatology, Peds Pulmonology, Peds Nephrology, Peds Urology, Peds Surgery, Peds Cardiology, Peds Neurology, Peds Heme/Onc, Peds Developmental, Peds Concussion/Sports Medicine, Peds Critical Care, General Peds (clinic and hospitalist), Peds Child Abuse, Peds Gastroenterology, Peds Endocrinology, Peds Rehab, Peds Infectious disease

EXPERIENCE

Please understand due to the nature of clearance and *clearance requirements, GHS Student Services can only clear students on an annual basis. If the student plans to be here multiple years, we would need to re-initiate clearance approximately 1 year from now. *TB, Flu and HealthStream assignments must be renewed annually. In order to ensure compliance, Student Services must re-initiate clearance.
Including an IRB Number will alert the GHS IRB of a new student participant. Please leave blank if there's no associated IRB study.