4th year Medical Students may use this form to submit a request for a SUB-I rotation at TidalHealth.

**Efforts will be made to accommodate your request; there is no guarantee that your requested rotation will be available.

Requests must be submitted at least 90 days prior to the desired rotation start date.

**TidalHealth is unable to sponsor Visa's for SUB-I at this time

Students must provide the following documentation to receive clearance to participate in a SUB-I rotation at TidalHealth; This information will be uploaded into our onboarding system if the rotation is accepted:

• Resume / CV
• MMR – proof of two vaccines or positive titer
• Varicella – proof of two vaccines or positive titer. History of disease is not accepted.
• PPD – TB Test or negative QuantiFERON within the past 12 months
• TDAP – within the past 10 years
• COVID-19 vaccine and any boosters
• Flu Vaccine (required for rotations during October through April)
• Background Check - within past 12 months
• 10 Panel Drug Screen – within past 12 months
• BLS card (American Heart Association)
• Student ID
• Driver’s License

Additional documents to be completed if request is accepted:

• TidalHealth SUB-Internship Agreement signed by the student, a school representative and the provider.
• Confidentiality of Information Statement
• IT Acceptable Use Policy Consent