Nursing Handbook & Policy Acknowledgements

Name*

First NameLast Name

Park Student ID*

Student Email*

example@example.com

Please complete each section below

Participation in ATI Components*

I have received a copy of the course syllabus, including the description of the ATI products.I understand that it is my responsibility to utilize the books, tutorials, and online resources available from ATI, as assigned by the Park University Department of Nursing

Academic Integrity*

I acknowledge and declare that I have read and understand both the Department's Statement on Academic Dishonesty (as located in the student handbook) and the University's statement and policy on academic dishonesty. I also agree to use APA formatting when citing my sources in all courses to learn, understand, and use the format required by my instructor.

Simulation Lab Policy*

I acknowledge I will be held responsible for the guidelines outlined in the Simulation Lab Student Policies (as located in the student handbook).

Photo Release Form*

I hereby consent to and authorize Park University, or anyone authorized by Park University, the use and reproduction of any video, photography or audio recordings taken of me on this date without further compensation to me. All originals and reproductions shall be the property of Park University, solely and completely.I do not consent to having my photo used.

Student Handbook*

I have been given a copy of the Nursing Student Handbook and understand I am responsible for reading, adhering to, and following all policies and procedures listed therein.

Statement of Confidentiality & Professional Responsibilities*

I have reviewed the Park University and nursing department standards of conduct and agree that, as a professional, it is my responsibility to be familiar with these policies and maintain compliance with them. I understand that these reflect current policies and may be subject to change. Information about updates and changes will be communicated to me via Park email.I understand that in the clinical setting I may have access to confidential information about patients, families, staff and facilities. I agree to maintain confidentiality of all information according to facility, federal and professional standards.I understand that it may be necessary for the nursing department to share student information as requested by healthcare agencies. I give the nursing department permission to share information requested by the health care agencies with which I have a clinical agreement.

Signature*

Date*

Date