Instructor, Staff & Scholar Onboarding Request

Please submit the following information for the instructor, staff, or scholar who needs Prisma Health Clearance. Upon submission of this form, the Prisma Health host/collaborator listed below will receive an email to confirm their partnership with you which then initiates the clearance process.

For more information, please visit our Instructor, Staff, and Scholar Clearance website.

Please note, the following groups are exempt from this process:
- ALL University of South Carolina School of Medicine medical students have been cleared through myClinicalExchange, have Prisma Health student badges and may enter the Prisma Health clinical learning environment as long as their compliance is up-to-date.
- Physicians with permissions to practice at Prisma Health already have Prisma Health badges through HR or Medical Credentialing Services. No additional clearance is required.

Prisma Health HSC Instructor, Staff & Scholar Clearance Request

Admin

College/University/Institution * College/University/Institution

Type of Instructor *

Please note, this form is not for students enrolled in graduate/doctoral degree programs. Please email Student.Affairs@PrismaHealth.org for assistance.

Specific Instructor Type

Will the instructor/staff/scholar be conducting research?

Yes

Would you like to submit multiple requests for clearance?

If you would like to submit clearance for multiple instructor/staff/scholars, you may use the following template. *

Maximum file size: 52.43MB

Instructor/Staff/Scholar Legal First Name *

Instructor/Staff/Scholar Last Name *

College/University Email Address *

Instructor/Staff/Scholar Phone

Anticipated Start Date *

Discipline or Department at University/College *

Where will the instructor/staff/ scholar physically work?

Is this instructor/staff/scholar an employee of Prisma Health? *

Yes, this person IS an employee of Prisma Health

No, this person is NOT an employee of Prisma Health

Prisma Health Service Line

Select the appropriate box.

Rounding Only

Accompany Students on Clinical Rotations

Prisma Health Department in which they will work *

For their role at Prisma Health, will this person engage in direct patient care? *

For their role at Prisma Health, will this person be in patient contact but not direct patient care? *

For their role at Prisma Health, will this person need to access patient data? *

Prisma Health Campus Host/Collaborator who can verify your position as an instructor, staff or scholar) * Prisma Health Campus Host/Collaborator who can verify your position as an instructor, staff or scholar)

Should anyone else be informed once clearance is complete?

Inform this person:

First

Last

reCAPTCHA

If you are human, leave this field blank.

Computer & Badge Accesses

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Admin

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