Lawrence S. Bloomberg Faculty of Nursing

Update BScN information sheet for Clinical Placements NUR371/372/373 – Rotation 3

Form
Personal Information Statement
Information Collected
  • As we approach the FINAL planning phase for assigning your clinical placements for Spring Term, we ask that you please let us know if any of your student information has or will change during NUR 371/372/373 rotation 3.

    Rotation 3 – May 1 – June 14, 2019

    This would include, for example, your living arrangements or mode of travel to clinical.

    If any of your information has changed since you last submitted this information to us, please use the following form to provide us with these changes. If all of your information remains the same you do not have to provide any updates through this form.

    ** Please note that the address you provide us MUST be the same as what is entered on ACORN (ROSI) and if there is any discrepancy we will use the address from ACORN (ROSI).


    Please Note: Spring term clinical placement days are as follows:

    NUR371: Wed 1 – 3pm; Thurs & Fri, 8-hr days

    NUR372: Thurs & Fri, 8-hr days

    NUR373: Thurs 10-hr days & Fri 8-hr days

    This link will open on March 25, 2019 at 9am and close on March 31, 2019 at noon – please submit any changes by this due date.  A late entry WILL NOT be accepted.  We cannot accept any email regarding your change of address, as the changes are tracked on our online forms.  Once submitted, you will receive an email notification advising that we have received your address change.


    The due date for this form has expired.

  • The University of Toronto respects your privacy. The information on this form is collected pursuant to section 2(14) of the University of Toronto Act, 1971. It is collected for the purpose of administering admission, registration, academic programs, university-related student activities, activities of student societies, financial assistance and awards, graduation and university advancement, and for the purpose of statistical reporting to government agencies. Your IP address and browser version are collected for Information Technology troubleshooting, as may be required. At all times, all data is protected in accordance with the Freedom of Information and Protection of Privacy Act. If you have questions, please refer to www.utoronto.ca/privacy OR contact the University’s Freedom of Information and Protection of Privacy Office at 416 946-5835, Room 104, McMurrich Bldg., 12 Queen’s Park Crescent West, Toronto, ON, M5S 1A8.

    I agree to have the information in this form plus my IP address and browser version be collected and stored electronically and I understand it will be protected in accordance with the Freedom of Information and Protection of Privacy Act. I understand that the information will be shared and viewed only by those who need to know. I also understand this form will be retained based on the University’s best practice guidelines for records retention, after which it will be destroyed in accordance with Information Technology Security best practices.

  • The following information is collected on the Form:

    Agree to personal information collection. Yes/No

    First Name

    Surname

    Preferred Name

    Student Number or Application Number

    UTOR email address

    WHERE WILL YOU BE LIVING DURING THE ACADEMIC YEAR?

    Address (Must be the same as what you provided on ACORN/ROSI)

    City

    Province

    Postal Code

    Major Intersection of above address

    Closest Subway/GO train stop

    My primary way to commute to clinical is:

    • TTC
    • Go Train
    • Other

    My alternate way to commute to clinical is:

    • TTC
    • Go Train
    • Other

    Can you commute by car to clinical?

    • Yes
    • No

    DO YOU HAVE ANY PERSONAL OR FAMILY RESPONSIBILITIES FOR US TO CONSIDER. (FOR EXAMPLE: CARE GIVING, ACCESSIBILITY/HEALTH CONCERNS)?

    It is helpful for faculty in matching available placements to students to know this information, however please be aware that accommodations may not always be possible.


    Other Data Collected  This data is collected for Information Technology administration and trouble shooting, as may be required.

    Date and time of form submission

    Your IP address (does not identify you)

    Your browser type and version number

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