The clinical mentorship documents below are completed using Microsoft Forms. Below are links and directions for completing each Form.
Clinical Mentorship and Facility Requirement Agreement - It is the VNDL student’s responsibility to share this link (click the link to open and then copy and paste the link from the address bar) with the facility owner or designee with signing authority of the facility at which you will be completing this Clinical Mentorship. This agreement is between the Clinical Mentorship facility and Purdue University. It states that the Clinical Mentorship site will provide you with the experience you need, including all equipment and supplies needed for the safe completion of tasks and that Purdue certifies that you are a VNDL student.
It is the student’s responsibility to make sure that the practice owner or designee completes this Form in a timely manner. For questions regarding the completion of the Facility Requirement Agreement, please contact the VNDL office (vetnurse@purdue.edu).
Each clinical mentorship has specific requirements for equipment and disposable supplies to which you must have access. If a veterinary practice does not have such equipment or supplies, or if these supplies or equipment are not accessible to you, you will have to select another site for your clinical mentorship for that particular mentorship experience. Each item box must be checked.
Each clinical mentorship must adhere to animal use guidelines that are described in detail in all VNDL clinical mentorship logbooks. It is essential to our program's accreditation that your experience observe these guidelines. You and your mentor must acknowledge animal care and use guidelines and agree to adhere to them.
Once the Form is complete and submitted, it is automatically sent to the VNDL Administrative Assistants.
Clinical Mentorship Supervisor Agreement - It is the VNDL student’s responsibility to share this link (click the link to open and then copy and paste the link from the address bar) with any licensed DVMs or credentialed veterinary technicians/nurses that will be supervising your completion of clinical mentorship tasks and to make sure that the mentorship supervisor(s) completes the Form in a timely manner. For questions regarding the completion of the Clinical Mentorship Supervisor Agreement please contact the VNDL office (vetnurse@purdue.edu).
Your mentorship supervisor(s) must know your rabies vaccination status in order to complete this supervisor agreement. This is to help ensure compliance with the AVMA/CVTEA’s rabies vaccination policy (unvaccinated students can only work with animals that have been rabies vaccinated) and for the safety of the student.
It is acceptable for students to have more than one mentorship supervisor in a semester. If you do have more than one credentialed vet tech and/or licensed DVM that will be acting as your mentorship supervisor during a semester, each mentorship supervisor must complete a separate Mentorship Supervisor Form. However, if you are taking multiple clinical mentorship courses in a semester, AND you are only using ONE clinical mentorship supervisor, only one supervisor agreement needs to be submitted.
Here are a few examples to help clarify:
Once the Form is completed and submitted, it is automatically sent to the VNDL Administrative Assistants.
Student Acknowledgment Form - Clicking this link will take you to the Form you must complete and submit to acknowledge your awareness of health risks related to the profession, technical standards, and rabies vaccination status. This form has several links to information that you will need to read, then check the appropriate checkboxes and sign/date at the bottom. When completing this form, you must select the appropriate checkboxes to indicate that you have read and agree to the information contained in the provided weblinks. Once you complete this form, it is automatically sent to the VNDL Administrative Assistants.
IMPORTANT** If you are taking multiple mentorships in a semester, you only need to complete one (1) Student Acknowledgment Form.
Professional Liability Insurance Coverage - Clicking this link will take you to the Form you must complete and submit for liability insurance coverage. Professional liability coverage for clinical mentorships runs from August 1 through July 31 each year. Regardless of what semester you register initially, it must be renewed each fall semester (August) if you are registering for a clinical mentorship in a fall semester. This form only needs to be completed once during the year/partial year of coverage. The $13 fee is billed through the Bursar, allowing it to be paid in the same manner that tuition is paid. Once you complete this form, it is automatically sent to the VNDL Administrative Assistants.
IMPORTANT** If you are taking multiple mentorships in a semester, you only need to complete one (1) Professional Liability Insurance Coverage form.
