Fillable Professional Experience Placement Student Declaration (James Cook University of North Queensland)

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Professional Experience Placement Student Declaration (James Cook University of North Queensland)

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Country of origin: AUSTRALIA
File type: PDF

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Professional Experience Placement Student Declaration
2021_Professional Experience Placement Student Declaration_V2.docx
Surname
Given Names
Student Number
Degree program
Mandatory Pre Clinical Requirement Declaration
I declare that (please tick):
I will complete all immunisation and health requirements, as required in the Course I am enrolled in.
I have complied with and will maintain all Professional Experience Placement requirements for my course as listed in the handbook
and where required I will provide evidence of completion of the requirements to the University. Professional Experience Placement
requirements may include, but not limited to:
a. A National Criminal History Check
b. A nationally accredited ‘Apply First Aid’ course from an Australian Registered Training Organisation
c. A nationally accredited CPR course from an Australian Registered Training Organisation
d. A Working with Children suitability check (Blue Card) issued by the Public Safety Business Agency
e. any particular Facility requirements of which I am notified from time to time
I will comply with any new or additional Professional Experience Placement requirements as notified or included in the
Facility requirements for Student placement.
I will notify discipline specific staff if I have a physical, psychological or any other condition that may impact on my ability to
undertake Professional Experience Placement and practice safely in the clinical environment prior to the commencement of
professional experience placement.
Where there is a pre-existing illness or disability such that your ability to practice in the chosen discipline may be
impaired, the student must advise AccessAbility Services, James Cook University.
I agree that while on Professional Experience Placement I will (please tick)
Practice within my scope of experience as a Student.
Wear the correct uniform and placement ID badge at all times (if applicable).
Adhere to the placement Facility’s procedures, policies and code of conduct.
Maintain the confidentiality of information concerning the personal affairs and health related information of Patients/ Clients of
the Facility in which I am to carry out my Professional Experience Placements during the length of the Course.
Notify the University and Host Facility of all non- attendance as soon as possible.
During my enrolment I acknowledge that (please tick):
I have read the current National Board policy for Registered Health Practitioners Social Media Policy and understand that it
also applies to students in Board-approved Courses. I am aware of the potential implications of online behaviour during social
media communication and that it may affect my professional life and registration.
I have read and acknowledged the current Procedure for Infectious Disease for Students within the Division of Tropical Health &
Medicine
I have read and understood the current Professional Experience Placement Procedures for Students within the Division of Tropical
Health and Medicine
I have r
ead and understood the current JCU Social Media Policy
I have read and understood the current JCU Student Conduct Policy
I have read and understood the current JCU Professional Experience Placement Requirements Procedure
I have read and understood the current JCU Review of a Student’s Suitability to Continue a Course Involving Placement
I have read and understood the current JCU WHS-PRO-023 Infection Control Procedure
Student Signature
Date
Important: Before emailing this document to dthmplacements@jcu.edu.au save it to your desktop
or placement folder. If you are using a Mac, please save the form as a PDF before submitting.
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Professional Experience Placement Student Declaration (James Cook University of North Queensland)

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Completed 29 March 2022

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