Clinical Student Rotation Registration
Please fill out the form below to register as a clinical student with Kintegra.
Required = *
District Of Columbia
Emergency Contact Info*
Columbus State University
East Carolina University
East Tennessee State University
Edward Via College of Osteopathic Medicine
Frontier Nursing University
George Washington University
Lenoir Rhyne University
Medical Centers Institute
Montgomery Community College
MUSC College of Nursing
NC A&T State University
Spring Arbor University
UNC Chapel Hill School of SW
UNC School of Dentistry
United States University
University of Cincinnati
University of South Alabama
University of South Carolina
University of Southern Indiana
Wake Forest University
Western Piedmont Community College
Winston Salem State University
Program/Placement Coordinator & Contact Info*
Clinical Rotation Specialty Needed*
Student Degree Program*
KINTEGRA ADULT & PEDIATRIC MEDICINE - XRAY DR
KINTEGRA BEHAVIORAL HEALTH - MOCKSVILLE
KINTEGRA BEHAVIORAL HEALTH - GASTONIA
Kintegra Family Dentistry - Gastonia
Kintegra Family Dentistry - Hickory
Kintegra Family Dentistry - Lexington
Kintegra Family Dentistry - Lincolnton
Kintegra Family Dentistry - Mocksville
Kintegra Family Dentistry - Statesville
KINTEGRA FAMILY MEDICINE - 3RD AVE
KINTEGRA FAMILY MEDICINE - BESSEMER CITY
KINTEGRA FAMILY MEDICINE - CHERRYVILLE
KINTEGRA FAMILY MEDICINE - HICKORY
KINTEGRA FAMILY MEDICINE - HIGHLAND
KINTEGRA FAMILY MEDICINE - HUDSON
KINTEGRA FAMILY MEDICINE - LEXINGTON
KINTEGRA FAMILY MEDICINE - LINCOLNTON
KINTEGRA FAMILY MEDICINE - STATESVILLE
KINTEGRA FAMILY MEDICINE - THOMASVILLE
KINTEGRA INTEGRATED MEDICINE - STATESVILLE
Kintegra Pediatric Dentistry - Gastonia
KINTEGRA PEDIATRIC MEDICINE - HUDSON
KINTEGRA PEDIATRIC MEDICINE - STATESVILLE
KINTEGRA TEEN WELLNESS - HUDSON
Terms & Conditions*
I authorize all educational institutions to release personal and professional information to Kintegra. I also consent to a criminal background search, if required. I further release Kintegra as well as those supplying said information, from any and all liability from these investigations.
I understand that Kintegra holds every employee, volunteer and student accountable under HIPPA. Sharing information regarding patients, employees, or the clinic to those not authorized to receive it is unlawful and shall be sufficient cause for my immediate dismissal.
I authorize Kintegra to complete a required health review to enter the clinical student rotation program. I will provide a recent (within 1 year) PPD (Tuberculosis Skin Test) result. I understand that any positive reaction to the PPD test may also be followed up with further testing.
I understand that any false statements on this application to Kintegra may be considered sufficient cause for dismissal.
I will provide Kintegra with sufficient notice regarding changes/absences from planned and scheduled work commitments.
I agree to undertake (or provide evidence of within the last year) OSHA/HIPAA training, and job related training as necessary and as specified by Kintegra, at no cost to me.
Agree with the terms and conditions
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It means a lot to us, just like you do!