Important Guidelines for Document Submission

  • Checklists are to be completed ONLY by students who have been admitted into the HCA program. As outlined below, certain items are due at specific times, so please read carefully.
  • All requirements are mandatory. Northwestern Polytechnic is committed to meeting standards of practice by ensuring that students attain and maintain required certifications and meet recommended immunization standards.
  • Returning students must ensure checklist requirements are up to date – Contact the department for information.
  • Students are responsible for paying any fees associated with obtaining these requirements.
  • Copies of your documents must be submitted to: @email
  • If possible, please submit documents all together in one email. Save your files as a PDFs and ensure the filename matches the form and your student ID number. (Example: Clinical_Placement_Agreement_8675309.pdf). It is a good idea to place all your saved documents in one folder for easy access if you are asked to provide them.
  • Please use your student email address and include "Checklist Documents" in the subject line. Sign the email with your name and student ID number.
  • If you fail to submit these documents within the specified time frame you will not be cleared for clinical and will be withdrawn from the course.
  • Note: Your certifications cannot expire during any clinical experience. To be eligible for clinical, you must recertify within the specified dates. This may mean recertifying before the expiry date listed on your certificate.
  • Students who are out of sync must ensure that documents are submitted as required in the applicable timeframe.
  • Please see the links below to access the required forms and further instructions. Note: Some forms may require additional time to complete.
  • Questions? Please contact our Clinical Placement Coordinator

Year 1 Requirements

The following items are due by September 30th (Grande Prairie Campus) and January 30th (Fairview Campus) or in your first year, depending on which campus you are attending. They will be discussed and completed in one of your classes during the first few weeks of September or January.

  1. HSPnet Consent Form
  2. Clinical Placement Agreement
  3. HCA Personal Declaration
  4. AHS Confidentiality Training Modules
  5. AHS Photo ID Badge/Access Card Request Form
  6. AHS Organizational Learning (Respectful Workplace) Modules
  7. Immunization and Practicum Disclosure Waiver Form
  8. Police Information Check Waiver Form
  9. Student Immunization Form: (Form to be completed by Public Health. Start working on this as soon as possible, no later than 60 days before the submission window).
  10. Mask Fit Test (must be dated within the submission window, valid for 2 years).
  11. Police Information Check with Vulnerable Sector (do not obtain more than 90 days before the submission window).
  12. Heart and Stroke Basic Life Support (BLS-CPR) Certification (Must be dated within the submission window).
  13. WHMIS

Documents and Instructions

The Health Sciences Placement Network (HSPnet) is a computer system used by educational institutions to arrange all clinical placements for students. Students are encouraged to read the HSPnet Identified Purpose and Handling of Personal Information for further information.

Instructions: Read, sign and submit the Health Sciences Placement Network (HSPnet) to @email