Orientation. Hotel Information: 929 Hingham Street, Rockland, Massachusetts, 02370, USA TEL:
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1 Orientation The Wellness Workdays Dietetic Internship mandatory orientation is scheduled for Monday, January 9, 2017 Friday, January 13, 2017 at The Double Tree Rockland, MA. Hotel Information: 929 Hingham Street, Rockland, Massachusetts, 02370, USA TEL: A block of rooms will be reserved for you more information to follow. To make your reservations, call and ask for the Wellness Workdays Block. Feel free to share rooms with other DI to decrease costs. Orientation Schedule: Monday-Thursday: *8:00am 5:00pm Friday: 8:00am 2:00pm* The hotel provides breakfast and Wellness Workdays will provide lunch for the duration of orientation. Dress is business casual. *To complete orientation successfully, you may not be late or leave early on any day during the orientation.
2 Professional Liability Insurance Student Proliability Professional Liability Insurance (Mercer Corporation) is the recommended liability insurance of the Academy of Nutrition and Dietetics. Please follow the instructions below to obtain student liability insurance. The Wellness Workdays Dietetic Internship requires you to carry liability insurance in the amount of one million dollars for the duration of the internship. Once you have completed the application process and paid the fee, please print and submit the memorandum of insurance (MOI) along with all other required documents on or before December 9, You must use a desktop or laptop computer to complete this process. You cannot apply using a smartphone, ipad or tablet www. Healthcare professionals drop down menu Choose student Professional organizations: click on Academy Answer the required questions about your coverage needs Review the no-obligation quick quote Submit application for underwriting approval You will receive a prompt to print your MOI Print a copy of the MOI and submit it to Wellness Workdays no later than Wednesday, December 9, Keep a copy for your records. You will receive the student rate for the state in which you reside. Prices may vary.
3 Required Proof of Drug Test Wellness Workdays must have proof of a five or seven-panel drug screen PRIOR to attending orientation and beginning your dietetic internship. Please follow the directions below to obtain this drug test. Laboratory locations and prices may vary depending on your geographic location. 1. Contact your primary care physician, an occupational health facility, urgent care or similar medical facility to request an employee drug screen 2. Request a self-pay chain of custody drug screen (Doctor s visit is not required) 3. Submit results and proof of screening to Wellness Workdays on or before December 9, 2016 *Please keep in mind that prices and insurance coverage for this screen may vary on an individual basis. This documentation is required to complete a dietetic internship.
4 Wellness Workdays Dietetic Internship Immunization Fact Sheet In order to comply with the Centers for Disease Control and Prevention (CDC) guidelines, interns are required to have up-to-date immunizations including: Two doses of Measles, Mumps and Rubella (MMR) vaccines or positive MMR titer. Booster does of Tetanus, Diptheria and Pertussis (Tdap) within the last 10 years. Varicella (chicken pox) titer indicating immunity or the Varicella vaccine. Hepatitis B vaccination three (3) injection series or documentation of a titer demonstrating immunity. Negative Pulmonary Tuberculosis (TB) or chest X-Ray if positive within past year. Influenza Vaccine Copy of Health Insurance Card INTERNS ARE FULLY SUBJECT TO THE POLICIES AND PROCEDURES AT EACH PARTICULAR SITE. The intern will be provided with an immunization form to be filled out by his/her physician. The intern will be required to submit copies of immunization records and proof of TB testing to the Wellness Workdays Dietetic Internship Program Director as well as their chosen facility. Interns should coordinate, ASAP, with the preceptor to see what additional immunizations the facility requires. Any costs incurred as a result of needing any immunizations or testing are the responsibility of the dietetic intern. Please fill out the attached vaccine administration record as necessary and submit all other proof of vaccinations to Wellness Workdays no later than Wednesday, December 9, Copies of vaccination records previously used for college or employment are acceptable.
5 Wellness Workdays Required Immunization Submission Form Please provide a record of your immunizations and complete and return the immunization chart on or before December 9, Wellness Workdays and the Academy of Nutrition and Dietetics (AND) requires a complete immunization record for all interns prior to attending orientation or beginning any supervised practice rotations. Acceptable records of your immunizations: Personal shot records that are verified by a doctor s stamp or contain a health provider s signature Personal shot records with a clinic or health department stamp Military records or World Health Organization (WHO) documents Previous college or university records that are verified. (Note that you must request a copy of these records from your college or university. Please leave ample time to complete this request.) Positive laboratory test as confirmation of immunity Be certain that your full name, as provided to Wellness Workdays, appears on each sheet and that all forms are submitted together. Complete these forms in black ink. The dates of vaccination administration must include the month, date and year. All records must be in English. Please keep a copy for your own records.
6 Please fill out the chart below, ensuring that all documents are included as attachments and submitted to Wellness Workdays, on or before, December 9, Vaccination MMR (Measles, Mumps, Rubella) Two doses required for all interns born after A positive MMR titer result may be submitted in lieu of vaccination history (attach copy titer result) Check if included Intern Initials Dose 1 given at 12 months of age or later Dose 2 given at least one month after first dose Tdap (Tetanus, diphtheria and acellular pertussis) Single dose required for all interns under the age of 65. Tuberculosis Screening Hepatitis B: Series of 3 vaccines, or positive titier (attach copy of titer results). May be combined with Hepatitis A Varicella: Series of two doses, given at least one month apart; Documented clinical history of chicken pox; or a positive varicella titer (attach copy of titer results) Influenza Vaccine (We understand that the flu vaccine is seasonal and may not be available at this time. You will be required to submit proof of vaccination at a later date if necessary.) (Intern s Printed name)
7 Required Projects: Rotation Clinical Long-Term Care Community Food Service Worksite Wellness Elective Required Projects Case study presentation and evaluation Journal article review with presentation and evaluation PES statement worksheet TPN worksheet No required projects Prenatal worksheets and project with evaluation Group nutrition education project with evaluation Food service audit In-service presentation with evaluation Cafeteria Meal Project with evaluation Wellness Project with evaluation No required projects
8 Required Background Check The Wellness Workdays Dietetic Internship requires you to complete a background check prior to attending orientation. Castle Branch ( is the required company for obtaining your background check and is compliant with all rules and regulations governing background screening processes and student record management. Castlebranch.com provides the healthcare-specific background screening searches required by The Joint Commission and this dietetic internship. Please follow the instructions below. A one-time fee covers the following required searches: Unlimited County Criminal Includes Alias/Maidens Nationwide Federal Criminal Nationwide Healthcare Fraud & Abuse Scan- FACIS Level 3 Nationwide Database Includes Sex Offender Residency History Social Security Alert Instructions: 1. Go to and enter package code WD43 2. You will be directed to set up your CertifiedProfile account 3. In addition to your full name and DOB, you will be asked for your Social Security Number, current address, phone number and address 4. At the end of the online order process you will be prompted to enter your Visa or Mastercard. Money orders are also accepted but will result in a $10 fee and additional turn-around-time. Please direct any questions about the required background check to: Debra Wein, MS, RD, LDN, CWPD President, Wellness Workdays Program Director, Wellness Workdays Dietetic Internship 21 Fottler Road Hingham, MA 02043
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Clinical Pre-Placement Health Form Program Name : RPN- Operating Room Due Program Code (#) 7945 Program Year Year 1 Program Descriptor Continuing ED. Student Last Name: Student First Name: Student I.D.