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Graduate Clinical Requirements: Evergreen Hospital & Medical Center | School of Nursing
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Graduate Clinical Requirements: Evergreen Hospital & Medical Center

Deadline/Where to Return Paperwork

At least 2 weeks prior to your clinical rotation. Send paperwork directly to the site.

Paperwork to Complete

1. Evergeen HIPPA for Covered Entities

2. HIPPA Assessment

3. Nurse Practitioner Application -  Ky Pham in Academic Servies will sign off on the immunization attestation form for you to put in with the rest of your application. Please contact Ky Pham at kypham@uw.edu for this portion of your application.

At least 2 weeks prior to your rotation, mail these to:

Lynnette Wahl, Administrative Coordinator - Education Department

425.899.2524 (p)  |  425.899.2459 (f) |   llwahl@evergreenhealth.com

EvergreenHealth MS-106, 12040 NE 128th St., Kirkland, WA 98034

Contact the Site

Midwifery students Only:

Diane Kovar, CPMSM
Manager, Medical Staff Office
Phone: (425) 899-1891
Email: dkovar@evergreenhealthcare.org

Diane will help you schedule an appointment to arrange completion of the remainder of your paperwork. Bring the following with you:

  1. Driver's license or passport
  2. Social Security Card

For ARNP/CNS students:

Karla Bushmaker, RN, MN
Staff Development Specialist
Phone: (425) 899-2529
Email: kjbushmaker@evergreenhealthcare.org

Additional Site Requirements

  • The seasonal influenza vaccination is required for all students coming to Evergreen for clinical experiences.