The following are the health and safety, and professional requirements for all students in the Department of Physical Therapy. These requirements are referenced in the University Calendar, section 205.60.2 (1-5) and must be met by the dates specified below.
No student will be permitted into clinical facilities unless health and safety requirements have been completed. Students are responsible for all fees associated with these requirements. Please submit photocopies instead of original documents. All forms can be found in the virtual filing cabinet.
Please submit documents in person to:
Shannon Kowalchuk, Clinical Education Assistant
2-50 Corbett Hall
University of Alberta
1. Police Information Check / Criminal Record Check
Alberta Health Services requires that all students placed within their facilities obtain a Police Information Check (also known as a Criminal Records Check or Security Clearance Check) which must include a Vulnerable Sector Check - and must be dated June 1, 2017 or later.
Please try to get this done at your local police detachment prior to coming to Edmonton. If you last residency was OUTSIDE Canada, you will be required to obtain a local check from your last place of residence. If that local police detachment will not provide a distance check (will not provide a check without you present and you no longer live there), we will need you to complete a form that states that you have made all reasonable efforts to obtain a local check.
Please do not have the results sent to us; the results are confidential and should be sent to you. You will need to show us the original copy (no duplications) of the PIC as well as submit a duplicate copy for your student file. This must be done by August 25, 2017.
If you have an unclear check, i.e. you have had a run in with the police or have been convicted of a crime, you must notify the ACCE as soon as possible so that further investigations with clinical sites can be completed.
2. Immunization Requirements
We strongly encourage you to have your immunization review at the University Health Centre (UHC) on the main campus. Please contact the University Health Centre to make an appointment as soon as you receive your letter of admission. Please bring your letter of admission as well as all childhood and previous immunization records to your appointment. Immunization records can be obtained by contacting your local public health centre, school, family physician, or wherever you may have had your childhood immunizations completed. Immunizations will be updated based on individual assessment. You can make an appointment with UHC as soon as you are admitted to the program and can make an appointment during clinic hours during June, July and August. Please note that as more students arrive on Campus, August becomes a very busy time for UHC, so book your appointment as soon as possible. Appointments must be completed by August 25, 2017.
Please note the forms below are posted on the University Health Centre website and can be accessed via the following link:
- 2017 Immunization Form Cover Letter
- 2017 Faculty Immunization Clearance Form
- 2017 Hep B High-Low Risk Flowcharts (MUST ACCOMPANY THE CLEARANCE FORM)
- 2017 Hep B Endemic Countries List
3. Cardiopulmonary Resuscitation (CPR)
Students must provide evidence of CPR certification at the Healthcare Provider HCP Level (Level C CPR certification is not acceptable) or Basic Life Support (BLS) Provider. These certifications are valid for one year. Evidence of annual recertification must be presented each year while in the Physical Therapy program. Students who do not have current certification cannot participate in clinical courses. On campus CPR courses are scheduled as options for students in the fall. It is recommended that you get a certification with mid-November dates, see CPR flyer for details. Proof of completion must be shown by November 24, 2017.
4. Respiratory Mask Fit Testing
N95 mask testing will be scheduled by the University of Alberta once your program starts.
Prior to acute care clinical practice courses, all students must be fitted for N95 Respiratory Masks in accordance with the contractual agreement with Alberta Health Services. These masks are worn when caring for patients with highly infectious diseases. The Physical Therapy Department will coordinate mask fit testing for all three campuses. The testing will take place in mid-November, more information will follow in early September. This must be completed by November 24, 2017.
N95 mask fit testing is valid for two years. If you lose or gain a significant amount of weight or have dental/facial surgery, you will need to have your mask fit test redone. Please note that mask fit testing is done only in the fall; if you require mask fit testing outside of this time frame it is your responsibility to independently obtain mask fit testing.
5. Personal Declaration Form
In order to ensure the safety of students and patients, students must be physically and mentally fit for clinical practice. Please carefully read the information in the Personal Declaration form and Requisite Skills and Abilities form. Sign and return the form to the main office by August 25th.
6. AHS Confidentiality Agreement
As a health science student you will be privileged to healthcare information and are bound by legislation to keep the information that you access confidential. In order to be able to access this privileged information you must watch the Information & Privacy and IT Security & Awareness video and complete the online learning module. You must print off the signed confidentiality and user agreement and submit to us by August 25th.
7. Disclosure of Personal Information
When signing this form, you will voluntarily authorize the university to disclose personal information to placement sites when required for the purpose of facilitating a clinical placement. This form must be submitted by August 25th.
The Health Sciences Placement Network (HSPnet) is a computer system used by the Department of Physical Therapy to arrange all clinical placements for our students. Students should read the Identified Purposes and Handling of Personal Information in HSPnet. Please sign and return the Consent Form for Use and Disclosure of Personal Information to the main office by August 25th.
9. Photo Release Form
As a student in the MScPT program, photos, videos or recordings may be taken of you for educational purposes. By signing this form you give consent to be recorded. This form must be submitted by August 25th.