Student Welcome Forms

We are looking forward to your arrival for your clinical affiliation within the Department of Rehabilitation Services at the University of Maryland Medical Center.

Required Paperwork to Return to Volunteer Services

Please download and complete:

• Health Clearance Form 
• Confidentiality of Information Statement
• Volunteer Application Form
• Background Investigation Form
• Dress Code and Personal Appearance Form
• Behavioral Standards Form
• Badge Access Form

Please also provide: 

• Documentation of titers, immunization records, flu vaccination, PPD, etc. (as outlined in Health Clearance Form above)

Please send to:

Volunteer Services Manager – Marvena Cole
Fax or email both acceptable.
Fax: 410-328-2924, include a cover sheet including your name, phone number, and ATTN: Marvena Cole
Email: mcole1@umm.edu

Required Paperwork to Return to Rehabilitation Services

Please download and complete:

• Health Clearance Form
• Confidentiality of Information Statement
• Important Information for all Staff to Know
• IS&T Applications Account Request Form

• Occupational Therapy
• Inpatient Physical Therapy
• Outpatient Physical Therapy
• Pediatric Physical Therapy
• Speech Language Pathology

• Learning Styles Form
• Student Introduction Form
• Allergy and Emergency Contact Form

Please also provide:

• Documentation of titers, immunization records, flu vaccination, PPD, etc. (as outlined in Health Clearance Form above)
• Documentation of completed Portfolio Epic Online Training
• Documentation of completed UMMS-U training modules (to be assigned by Volunteer Services upon receipt of paperwork)
• Copy of CPR Card

Please send to: 

PT/OT/SLP Clinical Site Coordinator – see below for specific point of contact

Fax or email both acceptable.
Fax: 410-328-2909, include a cover sheet including your name, phone number, and ATTN: PT/OT/SLP Clinical Site Coordinator
Email: refer to contact information below

Other Reference Documents

• Advice from former OT Students
• Advice from former PT Students
• Advice from former SLP Students
• Directions to UMMC
• UMMC First Floor Map
• Hospital Dress Code Policy

Contact Information

OT Clinical Site Coordinators

Margaret Barczak, OTR/L
Occupational Therapy Student Coordinator
Mbarczak@umm.edu
Office: 410-328-1739
Pager: 410-328-2337 (ID #8733)

Kate Heyman, MS, OTR/L
Assistant Occupational Therapy Student Coordinator
KHeyman@umm.edu
Office: 410-328-5516
Pager: 410-328-2337 (ID #10579)

PT Clinical Site Coordinators

Carly Pick, PT, DPT
Physical Therapy Clinical Site Coordinator
carly.pick@umm.edu
Office: 410-328-8217
Pager: 410-328-2337 (ID #5427)

Amanda Blorstad, PT, DPT
Physical Therapy Clinical Site Coordinator
ABlorstad@umm.edu
Office: 410-328-1739
Pager: 410-328-2337 (ID #10897)

Kristin Barron, PT, DPT
Assistant Physical Therapy Clinical Site Coordinator
kristinbarron@umm.edu
Office: 410-328-1739
Pager: 410-328-2337 (ID #12798)

SLP Clinical Site Coordinator

Catherine Franks, MS, CCC-SLP
Speech Language Pathology Student Coordinator
catherinefranks@umm.edu
Office: 410-328-5516
Pager: 410-328-2337 (ID #3898)