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Collaborative Nursing Degree Program Placement Forms

As a Collaborative Nursing Degree Program Student, your nursing clinical practice placement experiences will begin in Year 1. Placements take place in health and community care settings where patients receive health and care services.

You are required to complete the Practice Requirement Record (PRR) form and  Placement Information Record (PIR) form by the deadlines specified in the tables below. 

Students must complete these forms prior to being permitted to enter their clinical placements. Students who do not complete the forms by the deadline may be refused entry to their clinical placements.

DCSN has engaged with Synergy Gateway to provide access to Verified, external link, opens in new window. Students are expected to submit all PRR requirements as per the specific year and program. Students will receive an email from Synergy with an activation link to create an account in Verified, once the submission process opens for each semester. Students who already have an account can access their Synergy Dashboard. Please review the PRR package below for additional process details.

Placement Information Record

The PIR form allows students to indicate their practice areas of interest, such as community health, gerontology, or public health, and provide other details important to help coordinate and negotiate a variety of nursing practice experiences that will meet the objectives of Year 3 and 4 nursing practice courses.

PIR Forms and Deadlines

PIR is not used. Use the Student Site Selector on HSPNet, external link to search for available placements and rank your choices.

PIR is not used. Keep your address and contact information up to date in RAMSS and HSPnet, external link.

Form Deadline
PIR for Students entering Year 3  
Form Deadline
PIR for Students entering Year 4

Practice Requirement Record

The PRR form demonstrates that students meet the specific health and safety needs of placement partners.  It also proves that students abide by the requirements mandated by Ontario legislation for those entering into healthcare practice settings. 

Students will complete the PRR form on an annual basis.

All nursing students enrolled in practice courses must have their PRR completed and signed by their healthcare provider(s). Completion of all sections of the PRR form, by the dates specified on the form, is compulsory.  

This process is necessary to ensure that students protect their health and safety, and the health and safety of patients, clients, residents, visitors, employees and other students.

Student should allow themselves two to three months to complete their PRR. Students will need to present documentation for all required elements identified on the form by the deadline.

If students have not completed your PRR in time, the PDF filePRR Standard comes into effect. Without a complete PRR, placement partners can refuse students entry to their placement.

The PRR form includes the following medical requirements and non-medical requirements.

Communicable Diseases - Measles, Mumps, Rubella (MMR) and Varicella

  • Proof of MMR-V Primary Series Vaccination or 
  • Serology/Laboratory Evidence of Immunity

Hepatitis B

  • Proof of Primary Series Vaccination and Serology/Laboratory Evidence of Immunity

Diphtheria and Tetanus

  • Proof of the last Diphtheria and Tetanus vaccinations within the past ten years, and must be valid for the entire academic year


  • Proof of a one-time acellular Pertussis vaccination (TDaP or TDaP-IPV) given at age 18 years or older. If this information is no longer available, repeat the vaccination


  • Proof of Primary Vaccination only

Tuberculosis (TB) Screening

  • If Negative: Proof of Baseline 2-Step TB Skin Test required and Annual Step-1 TB Skin Test if Baseline was completed a year ago OR
  • If Positive: Proof of Chest X-Ray (CXR) report less than two years old, and must be valid for the entire academic year

Influenza Vaccine (For Winter Placements Only)

  • Proof of vaccine administered between October - December. This must be submitted for Winter Placement eligibility

COVID-19 Vaccine

Vulnerable Sector Screening/Check

The Vulnerable Sector Screening/Check (VSS) must be valid for the duration of your placement each semester and must be issued within six months of the start date of your placement. 

The CPO will automatically email all students enrolled in a practice course the Toronto Police form (M-postal code) or a Letter of Request (non-M postal code) to apply for a VSS each semester. Please do not email the CPO requesting for the form or letter. To avoid delays, please ensure your postal code is updated on HSPnet, this is how the CPO determines which document to send you.

Placement Semester

Expect Email from CPO
Fall 2022 Beginning of May
Winter 2023 Beginning of October
Spring 2023 (Post-Diploma Nursing Degree Program Only) Beginning of January

Mask Fit Testing

Proof of mask fit testing for N95 respirators is a mandatory requirement for nursing practice placements. This testing occurs every two years. In the Collaborative Nursing Degree Program, you will obtain mask fit testing in Year 1 and Year 3.

The Daphne Cockwell School of Nursing will offer mask fit testing twice a year on campus. This information will be shared with students once dates are confirmed.

Students who are unable to attend a scheduled session must arrange their own mask fit testing. It is your responsibility to arrange your own mask fit testing. There are several agencies across the GTA that offer mask fit testing for a fee, including, but not limited to:

At the end of your test, you will be provided with a mask fit test card. You will be required to show your mask fit test card annually for nursing practice placement clearance, as well as to your placement agency. 

If you are currently employed at a healthcare agency and have completed a mask fit test, you do not need to book a separate test. Please note that the mask fit must be valid for the full duration of your academic year.

Cardiopulmonary Resuscitation (CPR) Basic Life Support

You are responsible for arranging your own CPR classes at the Basic Life Support (BLS) level only.

Basic Life Support (CPR-BLS) is renewed on an annual basis and must be valid for the entire academic year.

Standard First Aid Certificate (Year 1 Nursing Students Only)

You must register either for the Standard First Aid in-class or Blended Format (First Aid and CPR-BLS) training course. You can register at any First Aid Trainers available in your area.

First Aid Certificates are valid for three years after the date of issue and must be valid for the entire academic year.

PRR Forms and Deadlines

Form Deadline (Fall)
PDF fileYear One PRR, opens in new window
December 2, 2022
Form Deadline (Fall)
PDF fileYear Two PRR, opens in new window
July 2, 2022
Form Deadline (Fall)
PDF fileYear Four PRR, opens in new window July 29, 2022