Rotation Checklist Form

Students who are electing to go to certain clinical rotation sites may be requested to provide documentation of immunization records.  If the site requires information to be completed on their form, Student Health Services can assist with the process.  Please follow the instructions below:  

NOTE: There is a $20 charge for each rotation form. Payment must be made before the form(s) will be started. Please make payment here.  Rotation forms are completed in the order they are received and may take up to 7 days or more to complete.  Please make sure that you have all of the required information, so that they can be processed in a timely manner.

  1. Complete the Rotation Checklist Form.
  2. Please complete the following at the top of the Checklist Form: Your full name, your date of birth (DOB), and student ID number the number of rotation forms you want completed.
  3. Obtain a copy of your current immunization record at (use your Outlook username & password to sign in). If you cannot access OSH (On Line Student Health), you can call Student Health at 706-721-3448 to request a copy of your current immunization record.
  4. Review your current immunization form and place a check by the immunizations, tests, etc., that you are missing but are necessary for the rotation site(s).   
  5. Once you have completed Step 4, please return the checklist and rotation site forms to the Student Health front desk personnel. (You may also send your forms to Student Health electronically via
  6. A Student Health clinic staff member will be assigned to your rotation forms and will review your checklist, rotation form requirements and your chart in order to assist you in completing your rotation requirements. They will correspond with you by email.

Rotation Checklist Form

Once your rotation requirements and forms are complete, you will receive your forms via your Augusta University email. If you need the original (hard copies) of your rotation form(s), please indicate this at the top of the form (þ box at top of checklist page). Original copies (hard copies) of rotation forms will be discarded after 60 days (your forms are electronically saved in your Student Health chart. 

Please call Student Health at 706-721-3448 if you have questions.