University of South Alabama College of Nursing
Important Forms for Practicum Students
Filling out a Form
All forms have to be completed before you can begin your practicum

Forms
Letter of Explanation to students/faculty from Dean, Debra Davis
Letter of Notification and Appreciation (1 Page Fillable pdf form- requires Adobe Acrobat 5.0 to complete online)
Two Page Agreement(Fillable pdf form- requires Adobe Acrobat 5.0 to complete online)
Statement of Liability Insurance Coverage 2013-2014
Combination of Practicum Prerequisite and Verification of Health Insurance Form (Fillable pdf form- requires Adobe Acrobat 5.0 to complete online)

For Additional Information

Office of Student Services
USA College of Nursing - HAHN 3082
5721 USA Drive N.
Mobile AL 36688-0002
(251) 445-9400
Email: conbsn@usouthal.edu
FAX: (251) 445-9416

The entry level baccalaureate program is approved by the Alabama Board of Nursing
and the BSN and MSN programs are accredited by the Commission on Collegiate Nursing Education
One Dupont Circle, NW, Suite 520
Washington, D.C. 20036-1120
Telephone 202-887-6791

The DNP program is accredited by the

Commission on Collegiate Nursing Education

One Dupont Circle, NW, Suite 530

Washington, DC 20036

(202) 887-6791.

https://jagpay.southalabama.edu/
University of South Alabama - Mobile Alabama 36688-0002 (251) 445-9400
For questions or comments Contact Us
http://www.southalabama.edu/nursing/cmnforms.html
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