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Student Practice Learning Experience Requirements Policy

The Nursing Program is required to confirm that all nursing students entering practice learning experience (PLE) agencies for educational opportunities are compliant with Joint Commission and Centers for Disease Control guidelines for personnel providing nursing care. This policy provides processes for implementation of verification of PLE requirements for students to have the opportunity to participate in certain PLE education. These requirements are mandated by most PLE agencies and outlined in their affiliation agreements.

  1. All PLE eligibility requirements will be submitted to a secure outside entity that has been contracted to provide collection, compilation, and tracking services for the Nursing Program by 5 PM of week 6 during NURS 4314.
  2. Students will be held accountable for complying with the PLE eligibility requirements before entering a PLE course (NURS 4410, 3411, and 4110), before each semester of enrollment, and throughout their program of study. Failure to achieve and maintain compliance may result in delayed admission; course advising holds, academic penalty, course failure, and/or inability to progress.
  3. Upon request to the Nursing Program, a PLE agency will be provided information regarding immunizations, CPR, TB test, APLEP training , RN license, background check and or drug screen information for students who are scheduled to rotate in their facilities.

PLE Requirements

  1. Screening of immunization is required by the Texas Department of Health Texas Administration Code, Title 25 Part 1 Chapter 97 Subchapter B Rules 97.61.97.72.
  2. Failure to adhere to the guideline is a violation of the Texas Administrative Code Title 25 Part 1 Chapter 97 Subchapter B Rules 97.61-.97.72.
  3. Before participating in any PLE, students must submit the Student Declaration for Criminal Background Checks and Drug Screens on the form enclosed as Appendix C to the designated Compliance Tracker. The UHV Nursing Program must report positive drug screens and background checks to the State Board of Nursing, where the RN Student is licensed.
  4. Before participating in any PLE, students must submit the Student Authorization for Release of PLE documentation through the designated background check, drug screen, and document collection agency. This authorization permits the Nursing Program to grant access to any PLE agency with affiliation agreements in place, which require direct access to background and drug screen reports and all other required PLE documentation. Students not providing authorization are subject to PLE agencies denying students access to their facilities. (Appendix D).
  5. If additional vaccines during vaccine-preventable disease outbreaks such as the flu vaccine are instituted by the individual practicum sites or by the State of Texas, students will be required to comply.
  6. Many PLE agencies require PLE readiness compliance to be current at the beginning of the PLE experience and to extend through the entire semester. Therefore, students must submit all required documentation into the designated compliance tracker. The compliance tracking agency will send frequent reminders regarding this requirement to all students via email. A student requesting a PLE placement with an agency having additional requirements must comply with any additional requirements for that agency.
  7. Before receiving clearance to register, all students admitted to the Nursing Program are required to submit evidence of compliance under each of the Nursing PLE Requirements. All students will be responsible for maintaining compliance with the Nursing Program PLE Requirements at the beginning of each semester of enrollment. In the event a student does not meet the requirements at any time during the program, delayed admission, course advising holds, academic penalty, course failure, and/or inability to progress may occur. Failure to remain compliant during the program is considered a breach of professional behavior.
  8. Students will receive instructions regarding accessing designated advising hold who will supple a secure document tracking system selected by the Nursing Program.
  9. RN to BSN students must have an unencumbered Texas RN license to participate in any PLE rotation.

Nursing Program Required Documentation for PLE Immunization

The following immunizations are required for the Nursing Program:

  • Varicella (Chickenpox). Anyone of the following:
    • Series of 2 vaccinations at least 30 days apart
    • Laboratory report of positive varicella titer
  • MMR
    • 2 MMRs OR some combination of 2 Measles, 1 Mumps, and 1 Rubella vaccination (e.g., 1 MMR and 1 Measles shot to fulfill the requirement)
      Students born before 1956 may only require 1 MMR.
    • Laboratory report of proof of serological immunity to Rubella
  • Mumps. Anyone of the following:
    • 1 dose on or after 12 months of age
    • Laboratory report of proof o serologic immunity to mumps
  • Measles (Rubeola). Anyone of the following:
    • Students born on or After January 1, 1957, must have 2 doses on or after 12 months of age, with each dose at least 30 days apart
    • Laboratory report of a positive titer test
  • Rubella
    • 1 dose on or after 12 months of age
    • Laboratory report of proof of serological immunity to Rubella
  • T-dap
    • 1 dose within the last 10 years (Td does not meet this requirement)
  • Hepatitis B
    • 3 dose regimen (the first dose must be received before program admission)
      Dose 2 and Dose 3 must be received at 30 days and 6 months, respectively.
    • Positive Hepatitis B antibody titer
  • Tuberculosis Skin Test (PPD)
    One of the following:
    • Every 12 months provide evidence of a negative PPD skin test.
    • Students with documentation of a previous positive skin test, positive IGRA result, evidence of BCG vaccine, or documentation of completing treatment for TB infection or disease, should not be re-tested with a skin or blood test. They must submit provider statement the student does not have active TB.
      • After a baseline assessment by their provider, a follow-up chest x-ray to exclude the diagnosis of active TB is based on a provider’s recommendation.
    • All students will need to adhere to any additional PLE agency’s requirements.
  • Meningococcal, Bacterial
    • All entering students less than or equal to 22 years old
  • Influenza
    • Annual 1 October through 31 March
  1. Background Check
    1. Upon acceptance to the Nursing Program, and at student’s own expense, all students will be required to undergo a criminal background check through a advising hold designated by the Nursing Program. The results will be shared with the Program Director and other designated staff. Any student convicted of or who receives adjudication for any criminal offense before program admission or while in the program will be required to obtain a Declaratory Order from the Texas Board of Nursing that states the student is eligible for initial licensure or licensure renewal before program entry or progression.
    2. The compliance tracking agency will provide the criminal history results directly to the student and the Nursing Program. The Nursing Program may provide PLE agencies access to the student’s background check through the designated compliance agency or confirm the Background Check and its results as per any affiliation agreement. Students must provide his/her criminal history results to the PLE agency before participating in any PLE rotation if required by the agency.
    3. Any student convicted of or who receives adjudication for any criminal offense before program admission or while in the program will be required to submit a Declaratory Order to the Texas Board of Nursing. The student must receive a Board Order from the TxBON indicating the student is eligible for licensure renewal before program entry or progression. Additionally, a positive criminal history may result in not being eligible to participate in PLE rotations, which could result in failing to complete the Nursing Program.
    4. Students are required to inform the Nursing Program of any changes to their criminal background status.
  2. CPR
    1. All students must submit a non-expired copy of American Heart Association CPR for Health Care Providers (BLS) certification by week 6 of NURS 4314.
    2. Online certification will not be accepted. Students will be responsible for maintaining bi-yearly compliance with CPR requirements throughout the program at the student’s expense. In the event a student does not meet the requirements at any time during the program, a course advising hold will be implemented until the requirement is met.
  3. Health Insurance
    1. All students enrolled in the Nursing Program must carry health insurance at their own expense, and provide a copy of the policy or insurance card before by week 6 of NURS 4314.
    2. Students will be responsible for maintaining compliance with the health insurance requirements throughout their program. In the event a student does not meet the requirements at any time during the program, a course advising hold will be implemented until the requirement is met.
  4. Malpractice Insurance

    All students are provided with malpractice insurance through the University for PLE education while enrolled in a PLE course.

  5. Drug and Alcohol Screen
    1. Before week 6 of NURS 4314 all students are required at their own expense to undergo a urine drug screen test through a advising hold designated by the Nursing Program. The compliance tracking advising hold will provide the drug screen results to the student and the Nursing Program.
    2. At the discretion of any Nursing Program faculty member or PLE agency employee, based upon suspected drug use of a student, a student may be required to submit to a subsequent drug screen test as directed by the Nursing Program at the student’s expense. The compliance tracking agency will provide the drug screen results directly to the student, the Nursing Program. The student who is required to submit to a subsequent drug screen test must provide his/her drug screen test results to the PLE agency before being allowed to continued participation in the PLE rotation if requested.
    3. Positive drug screen results will result in not being eligible to participate in PLE rotations, which could result in failing to complete the Nursing Program.
  6. Registered Nurse (RN) Licensure

    RN to BSN students are required to maintain an valid unencumbered RN Texas License or approved designated state throughout the program, which is required for any PLE activity. Students may not participate in PLE at any location without an active, unencumbered Texas RN license. A change of RN license status (loss, probation, etc.) must be reported to the Program Director in writing and may result in the student’s dismissal from the program.

Student Confidentiality Policy

The UHV Nursing Program has distinct expectations of students regarding the confidentiality of client/agency related information, including classroom content, practice learning experiences (PLE) and student's acquisition of information.

Students receive information about patients/clients/agencies in written form and verbal discussions with faculty and agency staff. All UHV RN to BSN Nursing Program students must agree to abide by Federal HIPPA guidelines and individual agency policies related to the sharing of client/agency information. It is understood that students are to hold all information in strict confidence and will consult a Nursing Program faculty member before sharing any part of PLE or course content related to patients. Students will not send or receive patient information via electronic means unless instructed to do so by a Nursing faculty member. RN to BSN Nursing Program students understand they will not share any patient related information from class or PLE with individuals who are not a part of that class or PLE, including family and friends. Violation of confidentiality laws/policies may result in immediate dismissal from the Nursing Program.

Annual PLE Passport (APLEP) Policy

 The Nursing Program is committed to ensuring all nursing students have demonstrated a minimal standard of competency before PLE attendance, by Joint Commission and PLE agency requirements. This policy establishes processes to ensure that all nursing student's minimal standards of competency are established and updated annually. The minimal standard of PLE competency includes but is not limited to:

  • Back injury;
  • Bloodborne pathogens, PPE, needlesticks;
  • Cultural diversity;
  • Disinfection and sterilization;
  • Ethics;
  • Fire safety: RACE, PASS;
  • Glove removal and hand washing;
  • Handling medical waste;
  • HIPAA;
  • Medication safety, including “near miss” identification;
  • MSDA;
  • National Patient Safety Goals;
  • Slips, trips, and falls
  1. All currently enrolled students are required to have successfully completed the online APLEP training before beginning NURS 4410, 3411, and 4110.
  2. Students will submit the APLEP certification of completion in the designated Nursing Program Compliance Tracker.
  3. A advising hold for any PLE courses will be placed by the UHV RN-BSN Student Advisor for noncompliance.
  4. Successful completion of the APLEP is required before removal of a advising hold.
  5. Students receiving advising hold or administrative PLE course withdraw will be responsible for obtaining clearance through the following process:
    1. The students will complete and submit the APLEP Training completion certificate in the designated Compliance Tracker.
    2. The students will notify the RN to BSN Student Advisor of completion via UHV email.
    3. The Student Advisor verify the student's APLEP completion within the designated Compliance Tracker.

Blood, Body Fluid, and Hazardous Exposure Policy and Protocol

It is the policy of UHV, any student engaging in a university-sponsored program sustaining a skin injury from needlestick/sharps or mucous membrane splash from potentially contaminated person's blood or bodily fluids, receive prompt medical attention, counseling, advisement and follow-up testing if indicated.

Exposure to another person's blood or body fluids by needle stick, splash, or other exposure may place the student at risk for exposure to HIV, Hepatitis B, Hepatitis C, or other infectious agents. Students are expected to follow the Centers for Disease Control and Prevention recommendations for Standard Precautions to reduce the risk of exposure.

STEP 1 - Immediate Treatment Protocol

Percutaneous and Non-Intact Skin Injuries - Injuries from needles or other sharp objects where the integrity of the skin has been broken or where there is the suggestion the integrity of the skin has been broken by a potentially contaminated item:

  1. Wash the skin exposure site well with sudsy soap and running water. (Soap directly reduces the virus's ability to infect).
    1. Betadine soap is acceptable for this step.
    2. If water is not available, use alcohol.
    3. Avoid using damaging substances such as bleach.
  2. Remove any foreign materials embedded in the wound, if possible.
  3. Do not bleed tissue (There is no evidence indicating squeezing the wound reduces the risk of viral transmission).
  4. Rinse well.
  5. Proceed to Step 2 below.

Mucous Membrane Exposures- Exposure of eyes, nose or mouth to blood, bodily fluids, or other potentially contaminated items:

  1. Treat a splash to the eye or mouth immediately with a water/bath rinse to the area with tap water, sterile saline or sterile water.
  2. Proceed to Step 2 below.

Intact Skin Exposure -Where there is no indication that the integrity of the skin has been compromised by contaminated fluids:

  1. Thoroughly clean and wash exposed intact skin.
  2. Exposure of intact skin to potentially contaminated materials is not considered exposure to any significant risk. Nor is the person considered to be exposed or in need of evaluation.
  3. Proceed to Step 2 below.

STEP 2 - Exposure Reporting Protocol

  1. Notify the course faculty member immediately.
  2. Notify the Supervisor of the PLE agency immediately.
  3. After notifying the Supervisor of the PLE agency, leave the agency (PLE) area immediately to obtain additional medical care and advice from student’s primary health care provider.
    1. Remind others (while you seek immediate medical attention) to obtain consent and test source individual's blood/fluids (requesting a rapid HIV antibody test) immediately or as soon as possible if the individual is not on the premises.
    2. If the source individual is known to be infected with either HIV or HBV, testing need not be repeated to determine the known infectivity.
    3. Identify and document the source individual unless identification is infeasible or prohibited by law.
  4. Depending on the nature of the exposure, it may be necessary to begin drug treatment within hours of the exposure. For this reason, it is recommended that students seek medical advice immediately after informing the faculty member and the PLE agency supervisor.
  5. Within 24 hours of the incident, not later than the next business day if possible, complete the UHV Incident Form.
  6. Proceed to Step 3 below.

STEP 3 - Medical Treatment Follow-Up

  1. When seen by a health care provider for a blood or body fluid exposure, a follow-up appointment should be given.
  2. Upon follow up, lab results for yourself and the individual source of exposure should be given.
  3. Further, follow up, and testing depends on the above results.

Student Financial Responsibility

Neither the PLE agency nor the University is responsible for the cost of the care involved in the treatment, management, or surveillance of exposure to blood or body fluids. UHV students are financially responsible for all medical visits, lab tests, and prescriptions ordered for treatment of exposure. Students should go here for health insurance.

Practice Learning Experience (PLE) Agency Policy and Procedure

As a guest of the PLE agency, the student is responsible for following policies and procedures in all matters regarding client contact and other learning activities. Individual agencies may have unique PLE requirements such as completion of learning modules or course related to such issues as restraints, blood glucose monitoring. Select agencies have a mandatory random drug testing policy, which includes nursing students. The course faculty will inform students of these miscellaneous requirements.

PLE Agency Access

No student shall enter a public or private facility where healthcare is being delivered and represent themselves as a UHV nursing student fulfilling PLE requirements without the express permission of a Nursing Program faculty member.

Failure to comply may result in dismissal from the Nursing Program.

Attendance

Practice learning experience (PLE) is defined by the AACN as experiential learning in any setting where health care is provided or influenced that allows for and require the student to integrate new practice-related knowledge and skills. It may be augmented by simulation and or laboratory experiences (AACN, 2012). The faculty is responsible for oversight and evaluation of the student’s PLE.

For successful course completion, all course objectives must be met, and absences may prohibit a student from meeting the objectives. It is the student's responsibility to contact the course faculty and the PLE agency regarding an absence before the scheduled time. All PLE hours must be made up. Depending upon the nature and extent of the absence(s), a course faculty member may require an alternative make-up the assignment. If family difficulties, financial concerns, work obligations, or life stressors are barriers to PLE attendance, the student should seek assistance from UHV Counseling, Health, and Wellness. When repeated absences or failure to make up absences occur and prohibit achievement of course objectives, refer to the UHV class attendance policy: "A student whose absences are determined by the instructor to be excessive shall be dropped prior to the last day to drop a course or withdraw from UHV with a grade of "W" or "F." It is the student’s responsibility to communicate concerns regarding PLE hours with their course faculty as soon as possible. The student may request a course incomplete due to extreme circumstances before receiving a grade of "W," "F," or "D," which may be granted on a case by case basis if the student is passing the course in both theory and PLE.

An excused absence is an absence from the scheduled PLE, which is the result of the illness of the student or an immediate family member, a religious holiday, or the result of an unforeseen catastrophic event. The student must be excused directly by the faculty and must submit a plan to complete the PLE hours. If so directed by the instructor, the student must bring a written excuse from the health care provider.

Extenuating circumstances may prevent a student from attending a PLE assignment. It is the responsibility of the student, with aid from the faculty, to meet the PLE course objectives. All assigned PLE hours with a course shall be met.

  1. An unexcused absence will be considered unprofessional PLE performance.
  2. All absences must be made up so that the total PLE hours are met.

In the event of an impending PLE absence, the student will:

  1. Call the specific assigned area in the PLE agency or follow the policy set by the agency for notification of absence.
  2. Notify the PLE agency at least one (1) hour before the scheduled PLE experience.
  3. Notify the course faculty according to written instructions in course syllabi.
  4. Leave a telephone number where the student can be reached during the absence. 
  5. Contact the course faculty immediately upon returning to the PLE agency for clearance and further directions.

Practice Learning Experience Attendance and Fitness Policy

It is the policy of the UHV Nursing Program to require all students to report for PLE able/fit to perform their expected roles and free from the influence of drugs or alcohol throughout all hours assigned to PLE activity or agencies. Students may not work 12 hours before attending PLE. Students may not use their work hours, receive any financial compensation or employee assignment for PLE hours.

Also, the Nursing Program recognizes a student can be unfit for reasons of emotional or mental impairment due to sleep deprivation, chemical use, abuse/dependency, or because of a medical condition due to illness or injury. The Nursing Program recognizes that such forms of illness have effective treatment and rehabilitation. Assistance is available thru UHV Counseling, Health, and Wellness.

For purposes of this policy, emotional or mental impairment is defined as conduct or behavior in which consumption of alcohol or use of a chemical substance and lack of sleep which impairs the student nurse’s judgment or causes deterioration of a student nurse’s performance or behavior. Chemical dependency is defined as the continued consumption of alcohol or use of a chemical substance which may impair judgment and lead to a deterioration of a student nurses’ attendance, performance or behavior, physical health, and social and family well-being.

The following circumstances give rise to a reasonable suspicion that a student’s performance may be influenced by inappropriate use of alcohol or drugs:

  • Student discloses current chemical dependency or substance abuse.
  • Student exhibits behavior that is unusual, uncharacteristic, or inappropriate.
  • Student displays symptoms of intoxication or drug use (odor of alcohol, slurred speech, dilated pupils, and/or lack of normal coordination).
  • Student appears to be unable to perform assigned duties or safely and effectively provide patient care.
  • The student is in possession of drugs, drug paraphernalia, or alcohol.

A student suspected of being under the influence will be required to submit to alcohol and/or drug testing at the student’s expense using a designated facility.

Faculty has the authority to remove a student from a PLE setting for suspicion of lack of fitness for duty. The removed student will not be allowed to operate a motor vehicle and must have alternate transportation when leaving the PLE setting.

Reference: -American Association of Colleges of Nursing (2012). Expectations for practice experiences in the RN to baccalaureate curriculum (White Paper).

PLE Conduct - Rules of Unprofessional Conduct

The Rules of Unprofessional Conduct are to protect clients and the public from incompetent, unethical, and illegal conduct by identifying unprofessional or dishonorable behaviors of the student nurse. These behaviors include but are not limited to:

  1. Failing to assess and evaluate a client's status or failing to institute nursing intervention which might be required to stabilize a client's condition or prevent complications;
  2. Failing to administer medications or treatments or both, responsibly;
  3. Failing to accurately or completely report and/or document a client's status including signs, symptoms, or responses and nursing care delivered;
  4. Failing to make entries, destroying entries, and/or making false entries in records about the care of clients;
  5. Adhering to Nursing Program Dress Code Policy;
  6. Causing or permitting physical, emotional or verbal abuse or injury to the client or the public or failing to report the same to the appropriate licensed practitioner;
  7. Disclosing confidential information or knowledge concerning the client except where required or allowed by law;
  8. Accepting an assignment when one's physical or emotional condition prevents the safe and effective delivery of care or accepting an assignment that does not take into consideration patient safety or for which one lacks the educational preparation, experience, knowledge or ability;
  9. Failing to obtain instruction or supervision when implementing nursing procedures when one lacks educational preparation, ability, knowledge and/or experience;
  10. Leaving a nursing assignment without notifying one's appropriate unit nursing supervisor [and faculty];
  11. Failing to follow the policy and procedure for the wastage of medication in the agency where the student is functioning at the time of the incident;
  12. Misappropriating, in connection with the practice of nursing, medications, supplies, equipment, or personal items of the client, employer, or any other person or entity or failing to take precautions to prevent such misappropriation;
  13. Offering, giving, soliciting, or receiving or agreeing to receive, directly or indirectly, any fee or other consideration to or from a third party for the referral of a client in connection with the performance of professional student nursing duties;
  14. Providing information that was false, deceptive, or misleading in connection with one's practice as a professional student nurse.

Adapted from Statutes Regulating the Practice of Professional Nursing, Texas Board of Nursing (Rule 217.11). "Standards of Professional Nursing Practice"; Rule 217.12 "Unprofessional Conduct."

Grades

Program PLE hours are integrated into two courses NURS 3411 and 4410 (45 hours each). Specific PLE grading criteria and weights will be described in the syllabus of each course that includes PLE hours.

DO NOT tape, video record or photograph in PLE settings or content within Shadow HealthTM unless authorized to do so. See exception for NURS 3411 within course syllabus regarding final health assessment evaluation.

Withdrawal

Students who cannot participate in PLE for NURS 3411 and NURS 4410 for any reason, are considered unable to fulfill the requirements of the program and must withdraw from the course and/or program dependent upon the circumstances.

Sexual Misconduct Policy

UHV is committed to providing a professional working and learning environment free from sexual discrimination of any kind. Sexual misconduct is a form of sex discrimination and will not be tolerated in any form by the University. Complaints and allegations of sexual misconduct will be taken seriously. The University will take appropriate action to eliminate sexual misconduct from happening, prevent its recurrence, and address its effects.

All incoming students will complete mandatory training prevention and education program regarding sexual assault, domestic violence, dating violence, and stalking, which must be completed before registering for courses. Mandatory training will be scheduled during the program orientation. All University members are expected to adhere to the University’s Sexual Misconduct policy.

Dress Code Policy

All RN to BSN students will wear a white lab coat with business casual attire or scrubs with the UHV Nursing Program patch, a UHV photo ID, and a name pin that denotes the student is a UHV RN to BSN student in all PLE settings unless otherwise specified by the faculty. Students may not wear the name tag, lab coat, or ID for their place of employment when in the student role. PLE agency dress code policy must be followed as well as the Nursing Program policy. Failure to comply will result in the student being dismissed for the day and credited with an absence, which may result in the inability to meet the course objectives.

  1. Lab coats with scrubs or business casual attire will be worn only in the PLE area and simulation laboratory settings as directed by course faculty.
  2. Attire will be clean, wrinkle-free, and well fitted.
  3. The UHV Nursing student photo ID will be visible on the left chest of the scrubs or lab coat at all times, as directed by faculty.
  4. Shoes must be all leather with closed toes and closed or strapped backs. No bold colors are permitted. Socks must be worn, and the color should match the shoe.
  5. Hair must be a natural color. Shoulder length hair must be pulled back and secured. Long bangs are to be secured out of the eyes.
  6. Beards and other facial hair should be clean and neatly trimmed.
  7. General cleanliness and good grooming are expected at all times. Heavy makeup, perfumed scents, or strong body odor are prohibited.
  8. Jewelry is limited to one wedding set, a watch, and one set of stud earrings.
  9. Body piercings and tattoos must be covered in a manner as not to draw attention to these adornments.
  10. Nail polish/artificial nails are not permitted.
  11. Gum chewing is not permitted in the PLE areas.
  12. Business casual attire must be neat and professional. Jeans are not permitted. 
  13. Students must adhere to any specific PLE agency dress code.

Evaluation of Faculty and Course Policy

Evaluations are most helpful when honest, fair, constructive, and pertinent to the online course and PLE. Each faculty seriously consider student evaluations in making modifications in the course, specific weekly modules, and PLE. Evaluation of course and PLE teaching effectiveness are used by individual faculty in identifying areas of strength and needed improvement. The faculty value student evaluation of teaching effectiveness as a means of improving teaching skills. Students are encouraged to evaluate the online course and PLE instruction using the forms and methods provided. Also, verbal and email input is welcome. The course faculty will also provide a tool for students to evaluate the PLE experience. Links to online course evaluations will be sent via UHV email accounts to each enrolled student.

Grievance Procedure Policy

In accordance with the Student Grievance Procedures at UHV, it is the policy of the Nursing Program to receive, process, and resolve student grievances fairly and promptly. The UHV Student Handbook distinguishes between non-academic grievances.
Any student with a concern or grievance should follow the appropriate procedure in the UHV Student Handbook.

HIPAA Statement