Skip to Content
Skip to Navigation

Graduate Clinical Requirements: Group Health Cooperative

Paperwork to Complete ( all NP students except midwifery)

Paperwork is available at:

NP paperwork can be sent to Roger Walker, please call Roger to set up computer access. Roger’s contact information is:

Roger Walker
Program Manager
Nursing Operations, Group Health Cooperative
Phone: (206) 448-6431

Midwifery students only

Paperwork Requirements - 4 weeks prior to your rotation

Paperwork for GHC Midwifery students is Mandatory.

Returning midwifery students  just need to enter your work orders that will update the location you're working at and extend your  termination dates. Please contact the Graduate Medical Education office for questions.

New students must  return forms via fax 206-877-0649, or scan and email to

1. Confidentiality Agreement

2. Privacy and Security Training

3. Extern Agreement for Non-Residents

Attached are the forms required by the GME department for onboarding the midwifery program students.  We need you  to sign and return the confidentiality agreement, complete the application, and review the privacy and security training manual to Group Health.  Included in the manual is a two page quiz.  The students are to circle their answers to the quiz questions and return JUST THE QUIZ and the other two signed documents via fax 206-877-0649 or scan and email to  We must have the completed forms in our office four weeks prior to the start date.


Graduate Medical Education
Group Health
320 Westlake Ave N  Suite 100, E2N
Seattle, WA 98109
Fax: (206) 877-0649

Additional Information

Influenza immunization is now mandatory for all Healthcare workers who work in facilities where patient care is provided or who provide patient care, including agency, contracted, students, interns, trainees, and vendors. Group Health implemented this policy in order to provide a safe environment for our patients and staff. Healthcare Worker compliance must be completed by December 28, 2012. Compliance consists of either being immunized or having a medical or religious exemption. 

Healthcare Workers that have a medical/religious exemption will be required to wear a mask when working in patient care areas once our Infectious Disease physicians have declared that flu is active in the community.  Should the flu season be declared prior to December 28, 2012, all unvaccinated Healthcare Workers will be required to wear a mask prior to December 28, 2012. After January 4, 2013 Healthcare Workers not in compliance with the influenza immunization policy will not be allowed to work at Group Health.