Lawrence S. Bloomberg Faculty of Nursing

Student Forms

Academic Programs

Undergraduate Forms
BScN Immunization Records (PDF)
BScN Request for Leave (PDF)
Procedures for getting a Vulnerable Sector Police Check 2013 (PDF)
Police Records Check LSBFON Guideline 2013 (PDF)
CNO Declaration of Registration Requirements (PDF)
BScN Information for Clinical Placement 2013 (online)
Critical Care Placement Application (DOC)
NUR470 Information sheet(DOC)
NUR 470 Bloomberg Choice Form 2014(DOC)

Master of Nursing & Post-Master Forms
Application for MN Degree (PDF)
Graduate Nursing Programs Immunization Records (PDF)
BCLS-Certification-and-N95-Testing (PDF)
MN Course Substitution Request (DOC)
MN NUR 1072 Preceptor Form – Winter 2014 (Online)
MN NUR 1072 Preceptor Form – Spring/Summer 2014 (Online)
MN Admin Field Course Planning Form (DOC)
MN Clinical Field Course Planning Form (DOC)
Suggested Course Progress (DOC)

Master of Nursing–Nurse Practitioner Forms
Health Status Requirements for Graduate and Nurse Practitioner Students (PDF)
MN-NP NUR1115/1116/1117 Preceptor Form, Fall 2013 (Closed)
MN-NP NUR1101/1102/1114 Preceptor Form, Summer 2014 (Online)
MN-NP NUR1110 Preceptor Form, Summer 2014 (Online)

PhD Forms
Declaration of Employment & Awards, 2012-13 (PDF)
PhD Examination of the Dissertation Proposal (PDF)
Faculty Certification of PhD Dissertation for Final Oral Defense (PDF)
PhD Program Plan (PDF)
PhD Supervisory Committe formation  (PDF)
Record of PhD Supervisory Committee meeting (PDF)
Statement of Supervisor–Student Agreement (PDF)

Revised PhD student forms – for 2013-14 student intake onward
Component Requirements for Candidacy – Sept 2013 onward (PDF)
Literature Review Paper Guidelines – September 2013 onward (PDF)
Thesis Proposal Requirements – Sept 2013 onward (PDF)
Thesis Format Options – Sept 2013 onward (PDF)
Examination of the PhD Dissertation Proposal Procedure, Guidelines, and Examination Report – September 2013 onward (PDF)


Clinical Placement Student Forms

Students on Unpaid Work Placements Accident Report (PDF)
HSPnet consent form for new Students (PDF)
Undergraduate Mandatory Clinical Attendance Guidelines (PDF
Notification of Absence Form (Online)


General Forms

Faculty Service Request Form (Online)
Verification of Student Illness or Injury (Online)
Request for Confirmation Letter (DOC)


Graduate Students

School of Graduate Studies (SGS) Student Forms (Link)

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