Learner Placement Request - Out of Province Institution

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Thank you for contacting the Saskatchewan Health Authority Learner Placement Unit.

The following form is intended for out of province educational institutions to request a learner placement with the SHA.

Please Note: The SHA LPU requires a minimum of 6 weeks notice prior to placement start day in order to ensure all required documentation is completed.

This includes, but is not limited to: a clinical placement agreement, workplace injury insurance, confidentiality/privacy forms, criminal record checks, respirator fit testing (if necessary), violence prevention training (if required), and immunizations.

Students are responsible for obtaining their own accomodation during placement.

If you have a question regarding learner placements with the Saskatchewan Health Authority, please Contact Us.

Please note, by completing this survey you grant permission to SHA to use the contact information provided for follow-up purposes. Are you completing this form on behalf of an educational institution or are you a student?

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Name of Individual Completing Form

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Your Email Address

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Student First and Last Name

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Students Email Address

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Students Province/Territory of Residence

Does your school, educational institution, or program have a practicum/placement coordinator?

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Please provide the name for your school or programs placement coordinator.

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Please provide the phone number for your school or programs placement coordinator.

Please provide the email address for your school or programs placement coordinator.

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What educational institution are you currently attending?

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What program are you currently enrolled in?

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How many clinical hours are required for this placement?

What credential will you be awarded upon graduation?

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Why are you interested in a placement with the Saskatchewan Health Authority?

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Have you already spoken with a Saskatchewan Health Authority clinician or clinical leader about a placement opportunity?

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Please be advised that the learning objectives must be provided prior to the placement being accepted.

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Please indicate the location the request has been sent to.

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What is the anticipated placement start date?

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What is the anticipated placement end date?

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Please list the top 3 preferences of the city or community where you would like your placement to occur.

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