CommUnityCare Clinical Placement and Internship Application Form


Thank you for your interest in CommUnityCare!


Please read below before submitting if you are applying for a clinical placement or internship.


You must attend a school CommUnityCare is already affiliated with:


  • South University
  • Texas State University - San Marcos
  • Texas Tech University - Health Science Center
  • University of Texas - Arlington
  • University of Texas - Austin
  • University of Texas Health Science Center at Houston
  • University of Texas Health Science Center at San Antonio
  • University of Texas - Tyler
  • University of Texas Medical Branch



The Department of Education and Research at CommUnityCare has deadlines for each applicable term for accepting requests for FNP clinical rotations:


Spring Term Deadline: November 30

Summer Term Deadline: March 30

Fall Term Deadline: June 30


If approved, The Department of Education & Research will reach out to you directly with instructions for collecting all supplementary onboarding paperwork required.


  • Students must be able to provide an attestation letter signed by their clinical coordinator clearing them of satisfactory background check, drug screen, and immunizations.


  • If you are not able to obtain an attestation letter from your school, you will need to provide your own satisfactory background check, drug screen, and proof of immunizations. These costs are independent of CommUnityCare and are at the responsibility of the student. A member of our team will reach out to you directly with next steps and instructions for submitting these confidential items.


Incomplete applications and requests submitted beyond the deadline dates will not be considered. Deadlines are critical in meeting the follow-up requirements in the event the student's rotation request is approved.


Please note that the Department of Education and Research will evaluate each application on a case by case basis to determine applicants appropriately.


Be sure to send a copy to yourself and preceptor (if applicable) for your records. A completed form does not guarantee placement.


For questions please contact: Educationandresearch@communitycaretx.org



CommUnityCare Compliance Modules required for placement:


Bloodborne Pathogens

Compliance Overview

Cultural Competency

Hand Hygiene

HIPAA Overview

Social Determinants of Health

CUC Emergency Codes

If you are applying for a clinical placement during the Spring, Summer of Fall semesters please note the enforced semester deadlines mentioned above.

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Affiliated University*
Program*

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When is the deadline to confirm a preceptor match with your school?

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Full name of preceptor/sponsoring provider. Leave this field blank if you are in need of a preceptor.

Preceptor Agreed?

Maximum of 180 hours is allotted for a clinical placement

Specific time and days of week preferred for rotating in clinic. Ex: M, W, F from 8am-12pm or T, Th 8am-5pm.

In 3-5 sentences please explain why you would like to complete a clinical placement rotation at CommUnityCare.

Please electronically sign here for the review of CommUnityCare's required compliance modules lined on this form.

How were you directed to our website?

Do you have an internal contact at a CommUnityCare clinic?

If approved, you will be able to provide the supplementary documentation required including:


  • An attestation letter signed by your coordinator clearing you of a satisfactory background check, drug screen, and immunizations.


                                        OR 


  • If you are not able to provide an attestation letter, you are aware of and capable of providing your own background check, drug screen, and immunization records within 30 days of acceptance notification.      


CommUnityCare Required Immunizations



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