Street Medicine Phoenix Application

Students/Volunteers

Clinical Preceptors

•Fill out application with CV or resume
•Submit vaccination records
•TB annually
•MMR
•Hep B series
•Influenza annually
•Hep A series
•Tdap or Td
•Submit BLS/CPR certification (must not be expired)
•Submit proof of completion of CITI training
•HIPAA
•Blood borne pathogens
•Credentialing through SHOW
•Volunteer application with CV/resume
•CITI training for ASU, UA, and ASU faculty
•HIPAA annually
•Blood Borne Pathogens annually
•Immunizations: MMR, Hep B series, Hep A series, Tdap or Td
•Annual TB skin test and influenza vaccination
•BLS/CPR and ACLS every 2 years
•Credentialing paperwork (MD/DO/PA/NP providers only)
•Board certification, DEA license, state licensure, and dispensing privileges (if applicable)