Clinical Rotation Faculty Registration

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hereby certifies that he/she has reviewed Lifepoint Health Criminal Background Check and Drug – Free Workplace policies, and that he/she has established policies wholly consistent with Lifepoint Health policies with respect to students assigned to complete a clinical internship at a Lifepoint Health facility. In addition, certifies that any Student assigned to complete a clinical internship at Lifepoint Health has successfully completed a criminal background check and drug screen, consistent with these policies.



Lifepoint Health is committed to providing a safe workplace and to protecting the safety and wellbeing of employees, residents, patients and others present at our business locations. Recognizing that drug and alcohol abuse pose a direct and significant threat to this goal, Lifepoint Health maintains a drug-free workplace. Lifepoint Health employees (except as required by employee's job duties), contractors, volunteers, students and affiliates shall not:

  1. Work for Lifepoint Health under the influence of drugs or alcohol.
  2. Possess, distribute, dispense, manufacture, sell, purchase, or misuse, attempt to possess, distribute, dispense, manufacture, sell, purchase, or misuse drugs or alcohol in the workplace or while performing work or representing Lifepoint Health either on or off Company premises, or while in a Company vehicle or during work hours, inclusive of breaks and meal times.
  3. Possess, distribute, dispense, manufacture, sell, purchase, or misuse, attempt to possess, distribute, dispense, manufacture, sell, purchase, or misuse drugs or alcohol on non-working time to the extent that, in the Company's opinion, it impairs an employee's ability to perform on the job or threatens the reputation or integrity of the Company.
  4. Obtain or attempt to obtain medications from the facility that are intended for patient/resident use.

"Drugs" and "Alcohol" include drugs and other mind-controlling substances, narcotics, alcoholic beverages, inhalants, prescription drugs and over-the-counter medications (except as noted below) and paraphernalia and literature related to drug or substance use.

"Drugs" and "Alcohol" (Cont'd) Prescription drugs being used upon the advice of a physician are exempted if used as prescribed and not abused. However, if you must use a prescription drug that may cause side effects such as drowsiness or impaired reflexes or reaction time, you must inform your supervisor that you are taking such medication. Use of alcohol at Company-sponsored events is permitted if approved in advance by senior management. Employees who participate in such events are expected to act in a professional and responsible manner.


To minimize the danger that drug and alcohol use poses, Lifepoint Health may conduct searches or tests. Drug/alcohol testing may occur when your work performance, conduct, appearance or behavior creates a suspicion that you may be impaired by drugs or alcohol. If you are involved in an on-the-job injury that results in either injury to you or another person requiring medical attention, or property damage, you may be required to take a drug/alcohol test. Individuals returning from a break in service exceeding three months may be required to pass a drug/alcohol test. Any employee returning to work after completion of a rehabilitation program may be required to pass a drug/alcohol test, as well as periodic tests thereafter.

Further, the Company may use post-offer, pre-employment drug testing. All offers of employment are conditional upon the applicant's successful completion of the drug screen, if such screens are performed. Reasonable searches of Company premises and employees, including personal effects, may be used when there is reasonable suspicion that an employee is in violation of this policy.


Failure to submit to a drug/alcohol test or a test that reveals the presence of identifiable traces of alcohol or illegal drugs regardless of when or where the substance entered your system is considered serious misconduct and may result in disciplinary action, up to and including separation. As a condition of employment all employees are expected to abide by this Drug-Free Workplace policy and report to Lifepoint Health, in writing, any conviction of a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction. If you have such a conviction, Lifepoint Health must respond with appropriate disciplinary action, up to and including separation.


Test results will be kept confidential to the extent possible. Information related to investigations conducted pursuant to this policy will be disseminated on a need-to-know basis in order to further the objectives of this policy and to comply with other Company policies or legal obligations.

Students’ Bloodborne Pathogens Education Verification

The Institution verifies that participating student in the Program has completed OSHA Bloodborne pathogens and HIV/AIDS education as required by the Federal Register 1910.1030 of December 1991.

Dated this the 24 day of March, 2023.