Student Clinic Council Leader and Volunteer Forms

Clinic Supply Order Form

Please complete this form if your clinic/program requires supplies that are not located in the communal supply closet. Vendors accepted through Tulane: Amazon, Staples, Medline, Fisher Scientific, Lowes, and more

ER Referral Form
  1. Let your faculty advisor and any member of SCC exec know that there is an ER referral happening

  2. Complete ER referral form, make a copy to keep on file at your site

  3. Write email detailing the referral and send to:

Monthly Leader Highlights/Shoutouts

Complete this form to give a shoutout to someone who you think deserves to be highlighted this month or a patient experience you would like to share with the group.

COVID-19 Concern Report

The SCC Incident Report is a way for students to easily report issues they’ve observed/experienced within Tulane’s student-run clinics within the context of the COVID-19 pandemic. As a reminder, you should NEVER be in contact with a COVID-19 positive individual while at the clinics and should always be in a face mask

Monthly Meeting Topic Suggestion Form:

In order for us to make sure your time is well spent at our meetings we’d love for you to fill out this poll with any topics you’d like us to cover at the SCC meetings! These can be specific topics (i.e. community resources) or talk topics (for speakers!)

SCC Volunteer COVID-19 Screening Form

Please answer the following questions prior to your scheduled clinic shift. If you have a fever (>100.4 F) and/or answer “yes” to any of the questions below, you may NOT participate in clinic. If you have a positive screen, we recommend you go to student health (if a student) or your healthcare provider (if not a student, i.e. attendings) and you MAY NOT come back to clinic for 14 days from the time you become symptom and fever-free.