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
- 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)
- Copy of CPR card
- Documentation of completed Non-Employee Orientation Modules on UMMS-U (will be assigned by Volunteer Services upon receipt of paperwork)
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
Contact Information
OT Clinical Site Coordinators
Kate Heyman, MS, OTR/L
Occupational Therapy Clinical Fieldwork Coordinator
KHeyman@umm.edu
Office: 410-328-0011
Pager: 410-328-2337 (ID #10579)
PT Clinical Site Coordinators
Amanda Blorstad, PT, DPT
Physical Therapy Site Coordinator of Clinical Education
ABlorstad@umm.edu
Office: 410-328-1739
Pager: 410-328-2337 (ID #10897)
Kristin Vick, PT, DPT
Physical Therapy Site Coordinator of Clinical Education
kristin.vick@umm.edu
Office: 410-328-1739
Pager: 410-328-2337 (ID #12798)
Lane White, PT, DPT
UMMC/PTRS Director of Student Clinical Practice
lane.white@som.umaryland.edu
Office: (410) 706-2308
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)