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Mailing Address:
The Valley Hospital
223 N. Van Dien Avenue
Ridgewood, NJ 07450
Preclinical Documents

Dear Clinical Faculty:

Thank you for choosing Valley Hospital for your clinical rotation. Our goal is to provide a safe learning environment for you and your students.

Unit-specific information, such as manager's name, email address, and telephone number, can be found by clicking on Unit Manager Contact Information. Unit-specific details can also be found by clicking on Clinical Unit Details.

All faculty and students need to complete required paperwork once annually, on a calendar-year basis. Please complete the forms listed below under the "Required Paperwork" section.

It is imperative that we receive all required paperwork, including the School Affiliation Roster, by the end of your first clinical day. Please return the paperwork to Aimee Lopez, NPD, Lower Level, Phillips 223 North Van Dien Avenue, Ridgewood, NJ, 07450. Incomplete paperwork cannot be processed, and will be returned to you for completion.

To view and print these documents, you will need Adobe Acrobat Reader. To download this software for free, please click here.

Required Paperwork

a) School Affiliation Roster - Student grades to be noted on roster. A Student Affiliation Roster must be submitted for all clinical rotation groups. If a student is returning within the calendar year, please mark “Returning student.”

b) Students & Supplemental Staff Self Learning Orientation Module Post Test - Please note:

  • Read each section.
  • Read instructions on front cover page.
  • Complete all tests and sign all statements, etc. included in the packet. 
  • MANDATORY: ALL tests and signed statements MUST be returned to the instructor on the FIRST clinical day. ALL paperwork is to be sent to Aimee Lopez, Clinical Education, Lower Level of the hospital. 

c) Mandatory Insulin Education - (included in orientation module above)

d) Annual Glucose Competency

Annual glucose competency is required of all instructors. Please run your high, lo glucose controls and complete the annual competency test. Please drop the signed competency form to Aimee Lopez's office, NPD Office, Lower Level, Phillips, 223 North Van Dien Avenue, Ridgewood, NJ, 07450. 

Please see the forms below for review:

NEW Competency Form
Blood Glucose Policy
Hypoglycemia Policy

For Instructor Information/Completion or for Review with Students

a) Nursing Student Clinical Assignment Sheet - Must be filled out and posted daily on the unit.

b) Post Test Answer Sheets - For grading and reviewing results with your students. 

Please return the paperwork to Aimee Lopez, Clinical Education, Lower Level, 223 North Van Dien Avenue, Ridgewood, NJ, 07450. Incomplete paperwork cannot be processed, and will be returned to you for completion.

c) Instructors and students coming to the hospital for clinical rotations must comply with the natural nail policy, located under Semester News on the left. Failure to comply will result in the loss of clinical privileges.

As a reminder, to take the shuttle to the hospital, you must park at 611 Valley Health Plaza, which is adjacent to the Luckow Pavilion in Paramus. The shuttle will drop you off on the 1st floor Phillips in the doctor's parking lot.

We are required by CMS guidelines for Inpatient Quality Reporting to provide documentation of influenza vaccination of our healthcare workers, including students and instructors working with patients at The Valley Hospital. Please provide us with this documentation for your students and instructors this upcoming flu seasonClick here to print the Influenza Vaccination Form. This is required.

Thank you for your cooperation. I can be reached at for any questions.


Lora Bognar

Lora Bognar, MSN, RN-BC, ANP-BC, Director, Clinical Partnerships and Nursing Programs



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