Clinical Placement
Lactation Educator Clinical:
Requirement is 8 hours or 8 patients with a lactation consultant or designate:
- If student does clinical where they are employed, most of the time there is no additional paperwork required
- Some facilities have minimal requirements for their own employees
- Clinical outside of student employer: General
- TB Test or equivalent, current within one year
- Insurance Requirement...
The insurance requirement for all students is $1/3 million coverage. A suggested company is listed. If you are an RN you must insure as a RN. If you are not a licensed health professional please use "medical technician" as the category for insurance.
Healthcare Providers Service Organization
159 E. County Line Road, Hatboro, PA 19040-1218
Phone: 1-800-982-9491 | Fax: 1-800-739-8818
Web site: www.hpso.com
Student Packet Check List
- PLEASE MAKE A COPY OF ALL FORMS FOR YOUR FILE
- Please download these forms, fill them out completely and submit to UCSD at
UCSD Extension
Attention: Nicole Mitchell
9500 Gilman Drive, Dept 0170E
La Jolla, CA 92093-0170
- For Clinical at Long Beach Memorial, Loma Linda Medical Center, Kaiser Riverside, or Sharp HealthCare there are additional forms that need to be completed. There forms are under the requirements for lactation consultant
Lactation Consultant Clinical:
Requirement is either 150 hours (students who work in the field of breastfeeding and/or are credentialed health care providers) or 250 hours for students who have minimal experience with breastfeeding:
- All students are required to submit all paperwork listed below.
- Paperwork may say Sharp Healthcare. All of this paperwork is required of all students.
- PLEASE MAKE A COPY OF ALL FORMS FOR YOURSELF
- To complete registration, all students must download these forms, fill them out completely and submit to UCSD at
UCSD Extension
Attention: Nicole Mitchell
9500 Gilman Drive, Dept 0170E
La Jolla, CA 92093-0170
- Dear Lactation Student,
All students of the UC San Diego Lactation Consultant training program are required to have a current Background Check and approved Drug Screening to participate in clinical rotations. UC San Diego is suggesting the Sharp Healthcare Background Check and Drug Screening as the standard to meet the requirement. The student must meet the requirement, but does not have to use the Sharp suggested procedure. Students not using the Sharp suggested procedure must clear their company of choice with UC San Diego Extension office by calling 858-964-1010.
Sharp drug screening procedure
- Current within 12 months TB
- Forms to be completed by all students:
Student Packet Check List
HIPAA Privacy Basics
Sharp HealthCare Compliance Education For Students/Registry
Sharp HealthCare's Commitment to Principles
Sharp HealthCare's Commitment to Principles Certification
Information Security Basics
- Insurance Requirement...
The insurance requirement for all students is $1/3 million coverage. A suggested company is as follows. If you are an RN you must insure as a RN. If you are not a licensed health professional please use "medical technician" as the category for insurance.
Healthcare Providers Service Organization
159 E. County Line Road, Hatboro, PA 19040-1218
Phone: 1-800-982-9491 | Fax: 1-800-739-8818
Web site: www.hpso.com
- If you are doing clinical time at any of the following facilities, please submit these additional forms:
- Kaiser Riverside: (only if going to Kaiser Riverside)
Confidentiality Agreement
Southern California Regional Attestation Form - HIPAA Security Training
Clinical Rotation Request
Principles of Responsibility
Commitment to the Principles of Responsibility, the Kaiser Permanente Code of Conduct
- Preceptor/Mentorship Application
Preceptor Student Requirements
Child Abuse Reporting Requirements
Elder and Dependent Adult Abuse Reporting Requirements Physician and Employee Acknowledgment
- Loma Linda: (only if going to Loma Linda)
Students should keep a set of this paperwork for themselves to take to clinical area AND Return a set of paperwork to Nicole Mitchell at UCSD
Lactation Consultant Program Clinical Form
Lactation Educator Program Observation Form
- Tracking form for students/individuals requesting hours for academic credit in a clinical area
- Student Orientation Guide
- Campus map
- Long Beach Memorial Care:
- Observers in Clinical Areas Information Packet and Application