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Graduate Clinical Requirements: Providence St. Peter Hospital


45 days prior to your rotation

Paperwork to Complete

Go to their website 

Click on Allied Health Students (under FOR HEALTHCARE PROFESSIONALS on the left)

Please return all paperwork to Jenn Rathe in Academic Services. The paperwork includes:

Pre-Arrival Checklist

Code of Conduct

Acceptable Use Agreement

Nondisclosure statement

In order for Academic Services to complete the Health Verification Form you will need to request your immunization summary at and send the summary to Ky Pham at who will fill out the health verification

Consent to Release Records Form. Please return this form to Compliance Specialist  in Academic Services. We cannot fill out the required Health verification form until we receive this consent.

The School of Nursing Will Provide to the Site:

  1. Access Request Form

Contact at Providence St. Peter:


Kathleen Rubida

Providence St. Peter Hospital

Education l Organizational Development

413 Lilly Road NE Olympia, WA 98502

t:360.493.4329 l f:360.493.7915