ADN Clinical Passport

Students applying to the Associate Degree in Nursing must submit a CPNW Clinical Passport demonstrating completion of specific immunization and certification requirements. During orientation, the Nursing Clinical Coordinator will review these Clinical Passports and work with admitted students to ensure that they are prepared to participate in clinicals upon beginning their first quarter.

Students should fill out the Clinical Passport digitally (do not handwrite or scan this form) and upload the Clinical Passport to their application as a non-editable PDF to prevent possible loss of entered information.

Clinical Passport Sections

The following sections should be completed or nearly completed when applying to the ADN program. The Nursing Clinical Coordinator will assist admitted students with fulfilling any missing requirements before the start of their clinicals.

  • “Submitted Once” section
    • Tuberculin status
    • Hepatitis B
    • MMR
    • Varicella
    • Tetanus/Diptheria/Pertussis
  • “Submitted Every Year” section
    • Influenza (first immunization)
      • If applying for Fall and last year’s influenza vaccinations are no longer available, you will have to get next year’s in August/September before the beginning of the program.

The following sections should be completed after being admitted to the ADN program. Applicants do not have to complete these before applying to the program.

  • “Submitted Once” section
    • Authorization for Release of Record
    • Additional Requirements
  • “Submitted Every Year” section
    • Tuberculin status (annual TST or IGRA)
    • Influenza (second and third immunizations)
    • Background Check
    • License
    • Insurance
    • AHA/BLS Course (can be completed prior to application instead)

Clinical Passport Resources

CPNW Clinical Passport

The Clinical Passport and required immunizations must be started before applying to the ADN program. All immunizations should be valid through the end of the first quarter in the program.

Clinical Passport Tutorial

The Clinical Passport Tutorial is provided by CPNW for clarification of the requirements for participating in clinicals. The tutorial is designed for clinical participation, so some sections are not required for application.

Sample Clinical Passport

Because parts of the Clinical Passport are submitted after acceptance, we have provided a Sample Clinical Passport with the required sections for admission highlighted.

All questions pertaining to your personal vaccine history should be discussed with your healthcare provider. Share copies of the clinical passport and the passport tutorial to gain further clarification. An additional resource for more information is the Center for Disease Control.

Additional Clarifications

Tuberculosis (TB)

Students must complete TB testing before orientation if admitted. The IGRA (Quantiferon) is a more accurate and quicker test (and should be used by applicants who received the TB vaccination while younger) but it is not always covered by insurance. If you instead wish to do the TB TST, please refer to the following guidelines from the CDC website:

Step 1

  1. Administer first TST following proper protocol
  2. Read result
    • Positive — consider TB infected, no second TST needed; evaluate for TB disease.
    • Negative — a second TST is needed. Retest in 1 to 3 weeks after first TST result is read.

Step 2

  1. Administer second TST 1 to 3 weeks after first test is read.
  2. Read results
    • Positive — consider TB infected and evaluate for TB disease.
    • Negative — consider person not infected.

Hepatitis B (Hep B)

Applicants should check on their Hepatitis B vaccination status before applying. Many applicants completed the Hep B series when they were younger and no longer have immunity to Hep B upon applying to nursing school. Applicants should visit their healthcare provider and obtain an antibody titer for Hepatitus B. If the titer is negative (no antibodies), the applicant must restart the vaccination series to obtain a positive titer. The three shot Hep B series without a titer will not be sufficient for completing the Clinical Passport requirements if admitted.

Return to ADN Requirements

Last Updated May 5, 2021