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COVID-19 is a highly contagious virus.  It is possible to develop and contract the COVID-19 disease even when individuals follow all of the safety precautions recommended by the CDC, the State of Vermont, and UVM.  The University is following all public health guidelines to reduce the spread of infection, however, by engaging in off-campus internships, clinical placements, or other practica (collectively “placements”), students can never be completely shielded from all risk of exposure or illness caused by COVID-19 or other infections.

ALL STUDENTS ENGAGING IN SPRING 2021 PLACEMENTS MUST ATTEST TO THE FOLLOWING AS A PREREQUISITE TO PARTICIPATION:

  • I understand that I am bound by the Green and Gold Promise while participating in an off-campus placement as if I was physically on campus.
  • I have completed the UVM Required COVID-19 Training in Blackboard and have submitted a certificate of completion to my academic supervisor.
  • I have reviewed the most current quarantine guidelines provided by the Vermont Department of Health, and for out of state placements the Department of Health in that state, and will comply at all times during the term of my placement.
  • I understand that my activities both during and outside of the hours spent at the placement site may impact my ability to meet health and safety guidelines. Specifically, while not at the placement site, I am encouraged to avoid unnecessary travel and practice physical distancing to ensure my ability to complete the placement experience is not unnecessarily compromised.
  • I understand that I am required to participate in appropriate orientation provided by the placement site covering, at a minimum, health and safety protocols specific to the placement environment.
  • I understand that whenever I am at the placement site, I am required to comply with site policies and protocols about health and safety, including use of personal protective equipment, appropriate hygiene, physical distancing, health monitoring, and reporting.
  • I understand that use of personal protective equipment (PPE) may be necessary based on placement site requirements. The placement site and UVM will work cooperatively to provide me with necessary PPE. I may, however, be required to provide my own basic facial covering.
  • I understand that students are encouraged to engage in placements via remote means, if possible. For placements that cannot be completed remotely, and are required program components, UVM will work with me if I am not comfortable or able to complete on-site placement due to health and safety considerations. I understand that, in some cases, this could result in a delay of my academic progress.
  • I understand that I am required to immediately share any health or safety concerns about placement site protocols or conditions with my academic supervisor, and I am never required to enter a placement site or engage in activities when I have such concerns.
  • I am required to report any injury sustained or infectious disease exposure to UVM Risk Management, my academic supervisor, and as may be required by the terms of the Green and Gold Promise.

Please log in to sign this form acknowledging that you will adhere to the protocol listed above.