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Clinical Badge Request Form


  • This Task has been designed for use by Students, Faculty, Staff. For Students, Faculty, Staff

Students may request a clinical badge using this form.  Students must be picked up badges they request in person at a campus library.

Instructors, clinical program supervisors, and program support staff may also use this form to request clincal badges for a single student or up to 20 students per form.  Badges may then be picked up by students at a library, or sent to a campus office or Center as indicated on the form.

Please CLICK HERE for clinical badge requirements and further instructions.


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