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 (Google Form)

    • Please complete the form and submit

Forms for Pocatello Site

All forms are due 4 weeks prior to the start of your rotation. Please send all forms to:

Tara Cottrell WWAMI Program Assistant OR Fax: 208-239-3434 (ATTN: Tara Cottrell)
  1. PMC S.T.E.P. Program Requirements, Agreement of Supervision, 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 Confidentiality Agreement
  5. WWAMI Pediatric Rotation Housing Agreement for Pocatello
  6. PCC Confidentiality Form
  7. PCC HER Access
  8. PMC Confidentiality Agreement
  9. WWAMI Pediatric Rotation Housing Agreement for Pocatello
  10. PCC Confidentiality Form
  11. PCC HER Access

Medical Student Coordinator Pediatric WWAMI Medical Student Office Seattle Children's OC.7.830, 4800 Sand Point Way NE Seattle, WA 98105 Phone: (206) 987-2063