Placement Forms

Prior to clinical experience you are required to submit a completed Health Assessment Form and/or an Immunization Form, in order to comply with the legislation and regulations of the institutions which offer field placements or clinical experiences.

1. Health Assessment Form:
Screening for immunity to certain diseases and verifying that your immunizations are up to date is a requirement of this program.

Health Form

Flu Vaccine Recommended. Please note:

  1. In the event of an influenza outbreak, learners will be allowed to work on the outbreak unit if they show proof of their influenza vaccination and it is a well- matched year.
  2. If the outbreak is a vaccine mismatch, learners will be allowed to work on the outbreak unit if they show proof of influenza vaccination and taking antiviral medication such as Tamiflu for the duration of the outbreak. The management and monitoring of Tamiflu for learners will be done by Algonquin College for the duration of the outbreak. Learners will be required to show proof.
  3. If a learner has not received the flu vaccine at least 2 weeks before the outbreak is declared, then the learner will need to supplement with Tamiflu until either: 1) it reaches 2 weeks since the vaccine was given, or 2) the outbreak declared over. Placements will not accommodate moving the learner to another unit during an outbreak.
  4. If a learner refuses Tamiflu and has been considered exposed, the learner cannot work in any clinical area for 72 hrs.
  5. As other placement accommodations will not be made if a learner does not have the flu shot, and is on a unit with an outbreak, the learner accepts the risk of reduced clinical hours, with potential impact on successful completion of clinical placement.

2. Police Records Check Documentation:

Successful completion of clinical placement is a requirement for graduation from the Personal Support Worker program. Agencies that provide placement opportunities require you to have a clear Police Records Check for Service with the Vulnerable Sector (PRCSVS). Your acceptance for placement is at the discretion of the agency. If you register in the program without a clear PRCSVS and as a result are unable to participate in placement, you will not be eligible to graduate.

Clinical Placement Eligibility

To be eligible for placement, you must submit proof of a clear PRCSVS, which will be retained on your departmental file and used only for purposes related to your placement. You will be required to disclose the contents of the PRCSVS, including all notations, to the placement agencies.

It is your responsibility to obtain the PRCSVS from your local Police Department prior to the deadline identified by your Department and to pay any associated costs. It may take a long time to obtain this documentation; submit your application as early as possible.

Clinical placements receive large numbers of health science students and there may be times during your program of study that require you to attend weekend and evening clinical experiences.

The following courses must be successfully completed before proceeding to Clinical Placement I (HLT0303): HLT0338, HLT0347, HLT0302, and HLT0343.

The following courses must be successfully completed before proceeding to Clinical Placement II (HLT0309): HLT0338, HLT0347, HLT0302, HLT0303, HLT0343, HLT0346, HLT0305, HLT0306, HLT0308.

The following courses must be successfully completed before proceeding to Consolidation Placement (HLT0310): ENL1813S, HLT0338, HLT0347, HLT0302, HLT0303, HLT0343, HLT0346, HLT0305, HLT0306, HLT0307, HLT0308, HLT0309 and PSY5609