Please review the required items on the application prior to completing the form. The application does not offer the capability of saving and logging back into it.
There is a document link at the bottom of the application. Please ensure that you either have the ability to download the file to your computer or onto a jump drive, so you are able to review the document while you take our online quiz. Once your application has been submitted, you will be automatically redirected to our Orientation Quiz.
8 hour job shadow to apply for YVC Radiologic Sciences Program
CRIMINAL HISTORY (RCW 10.97)
All information is required and failure to complete may affect results of inquiry and placement.
REQUIRED IMMUNIZATIONS
Health Requirements: Non-Employees (regardless of direct patient care) are required to meet the same health requirements as employees of Virginia Mason Memorial and its Affiliates. Health requirements are established in response to current Communicable Disease Center (CDC) for Healthcare Providers.
* Two-Step Tuberculosis Skin Test (TST) - and annual TB test thereafter. Documentation of at least 2 TST with most recent TST within 12 months of beginning student rotation. Annual TST required. Students with a history of positive TST must have documentation of a negative chest x-ray, negative QuantiFeron gold, or documented completion of INH treatment for Tuberculosis. An annual surveillance form for signs and symptoms of active tuberculosis is also required for any students with a positive TST.
* Influenza vaccine- Vaccine will be required annually between November 1- May1.
***VMM reserves the right to require other potential vaccinations as guided per recommendations of the CDC and adopted by the Infection Control Department.***
Virginia Mason Memorial (VMM) is responsible for securing its computer systems, associated data, and communications network. In addition, VMM and affiliated agency employees are responsible for preventing the occurrence of inappropriate, unethical, or unlawful use of such systems and data.
General Principles, Guidelines, and Enforcement:
Please refer to slides 42-49 and Appendix of Job Shadow Orientation (link below)
Please refer to slides 50-58 and Appendix of Job Shadow Orientation (link below)
CONFIDENTIALITY AGREEMENT:
I understand that I may have access to protected health information (PHI) and confidential information about the business and financial interests (referred to as "Confidential Information" in this Agreement) of Yakima Valley Memorial (YVM). I understand that Confidential Information is protected in every form, such as written records and correspondence, oral communications, and computer programs and applications.
I agree to comply with all YVM policies and procedures to protect the confidentiality of Confidential Information. I agree not to use, copy, make notes regarding, remove, release, or disclose Confidential Information, unless it is permitted by YVM policy.
I agree not to share or release any authentication code or device, password, key card, or identification badge to any other person, and I agree not to use or release anyone else's authentication code or device, password, key card, or identification badge.
I agree to notify the appropriate manager immediately if I become aware that another person has access to my authentication code or device, password, key card, or identification badge, or otherwise has unauthorized access to the hospital's information system or records.
I agree that my obligations under this Agreement continue after my employment or my time as a student or volunteer ends.
I understand that breach of patient confidentiality may result in civil or criminal penalties under state or federal law.
Please select the link below and download for reference regarding VMM, policies, safety, etc. The Job Shadow Orientation link will open the orientation training that will be used to complete your orientation quiz.
I grant permission to Yakima Valley Memorial and its affiliates to verify and obtain information on my employment, school records and license/certification. I hereby release my employers, schools, references, and any agencies contacted from any and all liability of damages for providing the information requested. Further, I certify that the above information is true and correct to the best of my knowledge. I also certify that I am in compliance with the required immunizations. I understand that misrepresentation or omission of facts is cause for rejection or termination of placement. Placement is contingent upon a satisfactory Criminal History Report. I understand that this application does not create a contract of employment or promise of future employment. I understand that my request for internship is voluntary, unpaid, and can be terminated at any time at the option of either the agency or myself.
My typed name below verifies that I have read and agree to comply with the above Confidentiality, HIPAA, Patient Rights, and Acceptable Use Policy. I understand my responsibility in protecting these rights. My typed name below shall have the same force and effect as my written signature.
If you have any problems with the application process, please contact:
Kandace Nash
Student Experience Specialist
kandacenash@yvmh.org
When you submit your application, please wait to be directed to complete the orientation quiz!
