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Student Education

*Be sure to have required documents ready prior to submitting your application.

Clinical Student Application

For students participating in hands-on clinical experiences that involve patient care, complete the application and orientation packet in link below:

Student Application & Orientation Packet

Observing/Shadowing Students

If you are a student seeking to shadow or observe, complete the forms in the link below:

Shadowing/Observing Forms

Orientation Videos

View the orientation videos using the link below:

View Orientation Videos

Holzer Health System extends a warm welcome to you and looks forward to supporting your educational journey with us. Please review the application requirements and complete the appropriate forms listed below related to your request.

Application Requirements

Applications must be received at least 10 business days before the rotation's scheduled start date and requires the following documents:

  • BCI and FBI criminal background check (done during the current academic year)
    • This MUST BE the actual report from the Ohio Attorney General's office.
    • When requesting FBI and BCI background check please use the following fingerprint codes FBI 173.41 and BCI 173.38.
  • Copies of:
    • Current Mantoux testing or QuantiFERON
    • Current Health History/Physical Exam (within the past year)
    • CPR certification (if applicable)
  • Immunization Information:
    • Hepatitis B (proof of Hep B series or declination form)
    • Tetanus
    • 2nd measles, mumps, and rubella, varicella (verification of history or vaccination)
    • Flu or declination form
    • CPR certification (if applicable)
  • Drug Screen Form:
    • STUDENT: A 10-panel drug is required before completing your rotation at Holzer Health System. This drug screen must have been completed during the current academic year and had the following drugs tested:
      • Amphetamine
      • Barbiturates
      • Benzodiazepines
      • Cocaine
      • Fentanyl
      • Methamphetamines
      • Opiates
      • Oxycodone
      • PCP Phencyclidine
      • THC
    • If you do not have a qualifying drug screen to submit, you may complete this at Holzer. Please print and take the linked form to one of the following clinic locations to complete this testing before submitting your application:
      Download/Print Drug Screen Form

Request for Nursing Student Clinical Placement

Complete the request for placement form using the link below:

Request for Nursing Student Clinical Placement form

Request for Phlebotomy Student Clinical Placement

Complete the request for placement form using the link below:

Request for Phlebotomy Student Clinical Placement form

Contact Us

Call or email for questions or assistance:

Requests for Placement

  • Nursing Clinicals and Preceptorship
    Susan Rowe: 740-446-5023

  • Nurse Extern
    Sarah Holland: 740-446-5213

  • Pharmacy
    Isaac Thompson: 740-446-5282

  • Radiology Tech
    Ted Adams: 740-446-5557

  • Cardiac Ultrasound: 740-446-5540

  • General Ultrasound
    Erica Jividen: 740-441-1942

  • Physical Therapy/Occupational Therapy
    Stella Barrett: 740-446-5122

  • Advance Practice Providers
    Patty Debruin: Email appstudents@holzer.org

  • Medical Students
    Whitney Riffle: 740-446-5768

  • Paramedics / EMS Rotations call for

    • Gallipolis - Tara Salyers: 740-446-5364

    • Jackson - Cynthia Workman: 740-395-8313

    • Meigs - Jennifer Cleland: jchasteen@holzer.org

STNA Classes
Ashley Jenkins: 740-446-5933 or email ajenkins@holzer.org

For all other student inquiries, contact Nathan Beaver at 740-441-8052.

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