Getting Ready

Pocatello, Idaho - PEDS 664

Getting Ready for your Pocatello Peds Rotation

The Pediatric WWAMI Medical Student Program will contact you via email approximately 5-6 weeks prior to the start of your rotation. This email will request that you provide the following information:

Student Biographical Information

Your first, middle and last name are required in order for you to begin your rotation.
Please complete this form and e-mail it to carla.salldin@seattlechildrens.org

Idaho Board of Medicine Form

This form is due 5 weeks prior to the start of your rotation and must have your signature on it.
You may send this form by e-mail, fax or a scanned copy to:

Adriana Olivas
WWAMI Program Operations Administrator
idwwami@uw.edu OR
Fax: 208-334-2344 (ATTN: Adriana Olivas)

Forms for Pocatello Site

All forms are due 3 weeks prior to the start of your rotation.
Please send all forms to:

Heather Gunter
WWAMI Program Assistant
hgunter@pocatellochildren.com  OR
Fax: 208-239-3434 (ATTN: Heather Gunter)
  1. PMC S.T.E.P. Program Requirements and Application Form
  2. PMC Orientation & Post-Test - Complete and return only the answer sheet with your name, date and signature
  3. PMC Verification Form/Health Screening Form
    1. The student must provide documentation of:
      • TB skin test within the last 11 months or if positive documentation of negative chest X-ray within the last 11 months.
      • Immunity to Rubella by 2MMR’s, history of disease or positive titer
      • Immunity to Rubeola by 2 MMR’s, history of disease or born prior to 1957, positive titer
      • Hepatitis B Vaccine in progress, completed series or signed declination form
      • Immunity to Varicella (Chicken Pox) by history of disease, positive titer, or 2 doses of varicella vaccine
  4. PMC I.T. Access Form
  5. PMC Confidentiality Agreement
  6. WWAMI Pediatric Rotation Housing Agreement for Pocatello

Medical Student Coordinator
Pediatric WWAMI Medical Student Office
Seattle Children's
A-5950, 4800 Sand Point Way NE
Seattle, WA 98105
Phone: (206) 987-2063