Nursing Student Checklist


Instructions: Initial each line item as it is completed. Complete all forms and documents in this checklist, compile them in numerical order, and deliver them to the Health Sciences staff assistant in the Health and Sciences Education Center, Room 133. You will then receive a referral form which you which you may take to the Advising and Counseling Center and register for classes.

____1. I have attached a signed and notarized the Affidavit of Good Moral Character form.
____2. I have completed a fingerprinting Level 2 Fingerprinting Background Check and read the information from the Florida Board of Nursing about licensure.
____3. I have completed the 10 panel drug screening as directed, and attached the blue copy.
____4. I have verified, with the Registrar’s Office, that my student contact information is correct.
____5. I have read the Nursing Student Handbook and signed the Student Handbook Signature Page. (Does not apply to Nursing Assistant)
____6. I have read the Consent/Student Confidentiality Agreement and signed the acknowledgment located in the Nursing Student Handbook. (Does not apply to Nursing Assistant)
____7. I have read and signed the Acknowledgment of Receipt of Notices of Privacy Practices.
____8. I have completed the Student Health History/Family & Personal History Form and attached the signed form.
____9. I have read and signed the Student Essential Technical Standards Form. My medical provider has completed the Nursing Student Health Forms. I have read and signed all forms.
____10. I have attached a copy of valid government issued photo identification or driver’s license.
____11. I have completed the Basic Life Support (BLS) for Healthcare Providers course and a current copy of my BLS card is attached. This card will be valid throughout my enrollment in the SFSC nursing program. (Only applies to LP to RN Transition Program)
____12. I will provide proof of any medical or other requirements upon request to representatives of SFSC Nursing Department/clinical affiliates.


Student Name (Printed):_______________________Student GID:_______________________
Student Signature:_______________________Date:_______________________
Reviewed By:_______________________