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Clinical Rotation Requirements: A Student Checklist

Before your first clinical rotation, your program and the clinical site will ask for a stack of documents: immunizations, a TB test, CPR, a background check, a drug screen, site training and sometimes insurance. Every site writes its own list, and the details (and deadlines) differ. Use this checklist to get organized, then check each item against your program's own list. If your school names a specific screening company, use that company.

Updated October 26, 2026 · Checked against the official sources listed at the end

Why every list is different

Clinical sites set requirements in their agreements with schools, and programs pass them on to students. One published example is the compliance checklist from UNC Health's Advanced Practice Provider (APP) Center for advanced practice nursing student rotations. It says the student shall not begin the rotation until the center sends a clearance email.

That is typical. Missing one item can delay your start. So treat your program's list as the final word, and use the items below as a guide to what to expect.

Immunizations

The UNC Health checklist asks for proof of:

MMR: two doses or lab proof of immunity.
Varicella: two doses at least 28 days apart, or lab proof of immunity.
Tdap: at least one dose after age 11, plus a Td or Tdap booster within the last 10 years.
Hepatitis B: the vaccine series, lab proof of immunity, documented non-responder status, or a declination on file at the school.
Influenza: an annual flu vaccine for the current season, with a deadline and no exemptions at that site.

TB screening and CPR

The same checklist asks for a baseline TB risk assessment, a symptom assessment, and a 2-step TB skin test or a TB blood test within 12 months of program admission or readmission.

For CPR, it asks for current BLS from the American Heart Association or the American Red Cross. Our guides on TB screening for healthcare workers and BLS card expiration cover these in more detail.

Background check

UNC Health's checklist asks for a criminal background check in every state where the student lived, worked or went to school in the past 7 years (or since turning 18, whichever is shorter), including a national sex offender database search. The check can be no more than 4 years old when the rotation starts, and the site decides whether a student with a flagged item can attend.

Some programs also require a state fingerprint check or clearance card, or a child abuse clearance. GateWay Community College's phlebotomy program, for example, requires an Arizona fingerprint clearance card, and Delaware County Community College's medical assistant program requires a child abuse clearance. Those run through state systems. Pact does not sell fingerprint checks or state clearances.

If your program accepts any provider, Pact sells a Standard background check ($32) and a Premium check ($70) that adds a 7-year county criminal search and a FACIS Level 3 healthcare sanctions search. See our guide to background checks for nursing and allied health students.

Drug screen

UNC Health's checklist asks for a urine drug screen no more than 12 months before the first rotation. It says dilute negative results are not accepted and the student must retest. It also lists the drugs the screen must include, and that list includes fentanyl.

Compare any site's list with the panel you plan to buy. Pact's $40 10-panel (Quest unit code 65190N) does not include fentanyl or alcohol, so it would not meet a list like that one. Pact's 5-panel with fentanyl ($89) adds fentanyl but has fewer drugs than the 10-panel, so check every drug on the site's list against the test you order. Our guide to drug tests for clinical rotations explains how ordering works when your program accepts any lab.

Site training: HIPAA, OSHA and more

Many sites have students complete their own training. UNC Health's checklist says all students must complete its regulatory compliance modules, which include a confidentiality statement, HIPAA training and OSHA training, before the rotation starts.

HIPAA counts trainees as part of a covered entity's workforce (45 CFR 160.103), and covered entities must train their workforce (45 CFR 164.530(b)). If your site provides its own modules, take those. If your program asks you to bring a certificate from an outside course, ask which courses it accepts before you buy one.

Bloodborne pathogens training is another common item. Our guides on HIPAA training requirements and who needs bloodborne pathogens training explain the rules behind them.

Other items to expect

Health insurance. UNC Health's checklist requires current coverage and says healthcare sharing ministries don't count.
Professional liability insurance, if your program or site requires it.
A site badge and any charting-system training the site assigns.
N95 fit testing, if your site requires it. See our N95 fit testing guide.

How to stay on track

Make one list with every item, its deadline and its expiration date.
Note windows: a drug screen within 12 months, a background check no more than 4 years old, a TB test within 12 months of admission, and an annual flu shot are all examples from one site.
Use the screening company your school names, if it names one.
Order early. State fingerprint checks and lab results run on their own schedules.

What Pact sells for this list

If your program accepts any provider: a $40 10-panel drug test, a $32 or $70 background check, and online courses from ProTrainings, including HIPAA and Healthcare Bloodborne Pathogens ($34.95 each). HIPAA is an online certification course from ProTrainings. Confirm with your program or clinical site that this course meets its requirements before you enroll. Healthcare Bloodborne Pathogens is an online certification course from ProTrainings. Confirm with your program or clinical site that this course meets its requirements before you enroll. Pact does not sell vaccines, TB tests, CPR classes or fingerprint checks. All sales are final.

Common questions

What do nursing students need for clinicals?

Usually immunization records, TB screening, CPR/BLS, a background check, a drug screen and site training such as HIPAA. Each program and site writes its own list, so use theirs.

How long is a clinical drug screen good for?

Each site sets this. UNC Health's checklist, for example, requires a urine drug screen no more than 12 months before the first rotation.

Do I need HIPAA training before clinicals?

Often, yes. HIPAA counts trainees as workforce members. Many sites assign their own modules, such as UNC Health's regulatory compliance modules, which include HIPAA.

Can I use Pact if my school names a screening company?

No. Use the company your school names. A result from another provider may not be accepted.

Does Pact sell fingerprint checks?

No. Fingerprint checks and state clearances run through state systems. Pact's background checks don't replace them.