Request for RN Refresher Clinicals

Thank you for your interest in performing your required RN refresher clinicals at Scottsdale Healthcare. Scottsdale Healthcare values those who have a reinvigorated interest in the nursing profession.

A current contract or affiliation agreement must be on-file with Scottsdale Healthcare Student Programs before your request for a clinical rotation will be considered. If your college or university does not have a current agreement on file, Scottsdale Healthcare may facilitate the agreement. All rotations are unpaid and are for school credit only.

RN refresher preceptorship requirements:
Request for RN Refresher Clinicals form
Resume or curriculum vitae
Contract/affiliation agreement between Scottsdale Healthcare and your school

Please fill out the form below. Bold fields are required.

Your Information

First name

Last name

Phone

Request deadlines for each year will be the following:

1. Spring Semester (for February to May start dates): December 1
2. Summer Semester (for June to August start dates): May 1
3. Fall Semester (for September to December start dates): August 1

Preceptorship Information

Name of RN Refresher Program

Required amount of on-site clinical hours

Approx. Proposed Start Date

Approx. Proposed End Date

Shift Requested

Requested Scottsdale Healthcare campus

First choice unit/department requested for preceptorship

Second choice unit/department requested for preceptorship

If your request for a preceptorship is approved, what do you hope to gain from this experience?

Please provide your resume or curriculum vitae by copying and pasting it below

When I click "submit" below, this form will be delivered electronically to Leah Hill, Student Programs Coordinator. This completed form (forms that are not complete will not be considered), and any documentation highlighting the requirements of the internship and must be received by the deadlines posted above. If your request is approved, a student orientation will be scheduled prior to your first day of internship. Per the affiliation agreement with partnered programs, certain health and safety requirements must be met before presenting to Scottsdale Healthcare for the student internship. Proof of requirement completions will be housed at the RN refresher program office, but must be available to Student Programs, if and when requested. Please see your school representative for more specific details about these requirements or click here.

Agree

By checking here, I acknowledge that the above information is accurate. I also authorize that this completed form any additional relevant information may be shared with Scottsdale Healthcare staff members for the sole purpose of networking and possibly fulfilling my request for internship.