For Clinical Instructors
The following documentation must be submitted for each clinical instructor each year two weeks prior to start of orientation:
- Instructor Information Sheet
- Pyxis/MedSelect ID Form
The following documentation must be submitted for each clinical group:
- Student Demographic information. (includes health records) MUST BE SUBMITTED TWO WEEKS PRIOR TO THE START OF CLINICAL.
- ProMedica - Student Intake and Health Records Form -Group Format (Nursing programs with clinical groups at Toledo Hospital and Flower Hospital will use different forms specifically provided to each program. Please contact Staff Development if you need this form.)
- Orientation Documentation/ Attestation Form
- Glucose Meter Education Documentation Form
- Glucose Education Module included in the library below.
The following training must be completed annually:
- Review the clinical orientation module. Contact site coordinator for additional site-specific requirements if any.
- Bixby Hospital – Pat Myers (517-265-0476)
- Defiance Regional Hospital – Carol Martinez (419-783-6942 – Fax (419-783-6904)
- Flower Hospital – Judy Horton (419-824-1226) – Fax (419-824-1761)
- Fostoria Community Hospital – Vanessa Billiot (419-436-6780) – Fax (419-436-6693)
- Herrick Hospital – Pat Myers (517-265-0476)
- St. Luke’s Hospital – Phyllis Haas (419-897-8404) – Fax (419-891-8092)
- Toledo Hospital – Mary Durfey (419-291-5532) – Fax (419-291-6460)
- Toledo Children’s Hospital - Mary Durfey (419-291-5532) – Fax (419-291-6460)
Document Library
Browse the appropriate folders below to view orientation files.




















