Forms
Refer to our Student Appeals page for more information on undergraduate appeals, which includes Academic Appeals, Practicum Intervention Appeal, and Code of Student Behaviour Appeals.
Undergraduate Clinical Forms
Refer to our Health and Safety Document Requirements for more details.
Checklist
Review the Health and Safety Checklist.
For more information regarding the process of requesting a deferred final examination, see Final Examination Deferral Student Process under Program Information.
Once you have reviewed this information, you may complete the following:
If you would like to exceed the maximum number of credits allowed by the Faculty of Nursing, you will need to request a Course Overload for a given term. Please email nursing.advisor@ualberta.ca to inquire about this option.
Course overloads will not be granted in terms with clinical courses.
If you would like to take a course at another institution while in the Faculty of Nursing, you must obtain permission from Undergraduate Student Services prior to registration. Your request will be reviewed by a Student Advisor once you submit a request for a Letter of Permission.
A Letter of Permission will not be granted in terms with clinical courses.
If you would like to take a break from your program for a period of 12 months, you are required to submit a Leave of Absence Request from your program.
Leaves of absence can only be granted for one year starting in a Fall term and returning in the following Fall term. If your request would be for alternate terms, contact the student advisor at nursing.studentadvisor@ualberta.ca.
Faculty of Nursing undergraduate students are required to report occasions of injury and other incidents. Routine incident reporting is required for situations of student injury ("workplace injury") or a patient safety incident. Critical incident reporting is required in addition to routine incident reporting in situations of serious risk or harm to a client/patient, student or faculty member.
Directions and forms for reporting are listed below.
Routine Incident Reporting
A) Workplace Injury
If you are injured or are exposed to human blood/body fluids during your clinical practicum let your clinical instructor know immediately. Your instructor will ensure that you receive first-aid treatment immediately and make the charge nurse aware of the incident. You will follow the protocol of the agency in which you are injured.
As a University of Alberta student, you are required to fill out the University of Alberta Incident Report and the University of Alberta "Workers' Report of Injury or Occupational Disease" form for the Workers' Compensation Board-Alberta (WCB). Your instructor has a copy of the WCB forms. The WCB form is time sensitive and must be submitted within 24 hours of the injury occurring.
If you cannot complete all of the information, for example you are not sure of your social insurance number or health care number, send in the document with the information missing. This information can be added later. The forms need to be returned to the Faculty of Nursing. Fax completed forms to: Denise Pasieka, Clinical Placement Coordinator, 780-492-2551. Ensure that you verify that the forms have been received by sending an email to dmcavoy@ualberta.ca or by calling 780-492-8645.
- University of Alberta Incident Report (CCID required)
- Worker's Report of Injury or Occupational Disease (pdf) WCB Forms need to be submitted to Denise Pasieka. Do not follow the WCB submission guidelines.
B) Patient Safety Incident
You are required to complete the incident report form used by the clinical agency where the patient is situated.
Critical Incident Reporting and COVID-19 Reporting
In situations of serious risk or harm to a client/patient, student or faculty member, and in situations of exposure to COVID-19 and/or if experiencing COVID-19 symptoms you are required to fill out the Faculty of Nursing Critical Incident Report (Google Form).