Welcome to Bon Secours Richmond Community Hospital, we are glad you have chosen us for your clinical practicum experience.

Facility Map

Facility Coordinator: Sarah Gardner, RN-BC, Clinical Educator

Phone: 804-764-7563

Email:  Sarah_Gardner@bshsi.org


The Confidentiality and Security Agreement for, the Student Agreement Form, and the Student Orientation Guide Attestation Page must be SIGNED, SCANNED, and EMAILED to the facility coordinator three (3) weeks prior to your START date.  Please also include your Course Syllabus and Learning Objectives.

Confidentiality and Security Agreement

Student Agreement Form

Student Orientation Guide with Attestation Page

Syllabus/Learning Objectives From your University or College
Contact facility coordinator for a list of required Immunizations.

Complete and submit the form below in order to have appropriate access to our systems.  We look forward to participating with you in your Professional Development as a Registered Nurse:


First Name *
Middle Initial *
Last Name *
Current Mailing Address *
Home Number *
Cell Number *
Email address *
College or University *
Class Course *
Course Start Date *
Spring Semester *
Course Professor/Instructor *
Contact Number *
Anticipated Graduation date *
Nursing Unit where Practicum will be completed *
Hospital Location *
I certify that I have signed and faxed the Student Agreement and Student Orientation Guide Attestation Forms.
 Signed Confidentiality and Student Agreement *
* required fields

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