Student Affiliation Program

Student Affiliation Program

Definition: A formal program of study in which the student is currently enrolled in an school sponsored, credit class or program and is seeking a rotation at Community Medical Center. A formal affiliation agreement between the school and the facility has to be in place for this program. Please contact the Student Coordinator at (406)327-4009 mphillips@communitymed.org  if you have any questions about an agreement for your school.

Note: If you are a Medical Student - please find your needed documents here

An affiliation agreement needs to be in place to go forward with a student placement for educational rotations. This can sometimes take some time. Please contact us as soon as possible to ensure an agreement is current and in place well in advance of an educational experience. This cannot be done by the individual departments and must be approved by the Student Affiliations department.

Paperwork, Documentation and Requirement Information for Rotations

Please review the attached documents that include the requirements for doing an educational rotation at Community Medical Center

Student Instructions and forms:

  1. Review Western MT Student Checklist/Orientation Manual (Read only)
  2. Disaster_Brochure.pdf (Read only)
  3. RCCH Code of Conduct (Read only)
  4. Tobacco Free Policy (Read only)
  5. Background Check/Release Form (Print and return)  Fill out Background Release Form in case we need to get a copy of the background check from the school for an audit or submit a copy of the background check with the Background Release Form. In some cases the school may not provide a background check for students. If this is the case, the student will be responsible for providing a criminal background check along with exclusion list checks from  the national sexual offender registry search http://www.nsopw.gov/en-us Pleas.e check with your school contact to see if this is your responsibility to avoid delays in starting your student experience with Community Medical Center.
  6. Fill out Student Checklist (Print and Return)
  7. Fill out Security Badge Access Form  (Print and Return)
  8. Fill out Statement of Responsibility and Confidentiality - 2 forms  (Print & Return)
  9. Fill out IT Terms and Conditions   (Print & Return)

Other Student Forms (Nursing Students only)

  1. Glucometer Test (Print & Return)
  2. Glucometer Policy (Read only)
  3. Pyxis ID Request Form (Print & Return)
  4. Nursing only Checklist (Print & Return)
  5. Nursing Student CERNER Access Request Form  (Print & Return)

School Instructions:

  1. Fill out Immunization Verification Form (Print & Return)
  2. Fill out School Checklist (Print & Return)
  3. Fill out Student Placement Tracking Form (Print & Return)
  4. Please e-mail Hope Evans hevans@communitymed.org    the completed Nursing Student CERNER Access request form for Student Cerner access. Please call 406-327-4038 for quetions.
  • Fill out the school portion of the Background Release Form after the student has filled out their portion of the form unless the student is providing a copy of the background check with the release form. The background must include a national sex offender search and an exclusions list check as well as the national criminal background check

  • Any documents that need to be filled out (not including the documents that were for review only) will need to be turned into The Human Resources Department  by the student to receive CMC ID Badge and prior to the start of a rotation. The student  must present a state or government issued ID in order to obtain their CMC ID badge. 

Contact Information

Maria Phillips, Student Coordinator
Phone: (406)327-4009
Fax: (406)327-4497
Email: mphillips@communitymed.org