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Nursing Project Application

Nursing Project Application

All students completing any kind of project or research study at Gundersen Health System must have Human Subjects oversight. You must have your cover letter or introductory letter and resume documents available to send via email once you complete this application. As your project gets closer, you must submit the Student Project Template. Completion of this application does not guarantee that your project will be approved.

NOTE: If you are in need of a project or research study AND clinical hours, please complete the application for clinical hours instead of this application. You can include your project request in that application.

Completion of this application does not guarantee that your project will be approved.

Please understand you must go through the Medical Education department to request your project proposal in any Gundersen Health System facility.

The appropriate contractual Affiliation Agreements for Gundersen Health System must be in place prior to clinical placement. If a contract is needed with the school/university for student placement, please note:

  • This process can be lengthy and does not guarantee student placement
  • There is no guarantee that a contract will be successfully negotiated
  • Student cannot be placed or start a project until contract is in place

Basic information

Address
Are you a current Gundersen employee?

School information

School address

Licensure

In order to complete clinicals at GHS, you MUST have a valid RN licensure that will not expire during your clinicals. Your licensure MUST be from a Compact State at the time of submitting this application.
RN Licensure

Student project

Anticipated project start and end dates
more items
Facilitator/Champion/Mentor Requirements
Check all that apply
Do you have a facilitator/champion/mentor in mind that you would like to reach out to?

By typing my name below, I acknowledge that all Nursing project requests must come through the Medical Education department. I understand that an affiliation agreement needs to be in place between my school and Gundersen, the Student Project Template must be completed, the project must be vetted by the Gundersen project vetting committee, and I must go through human subjects oversight prior to starting any project work. 

A friendly reminder: Do not reach out to providers on your own, placement must go through Medical Education. Thank you.

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La Crosse, WI 54601

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