Thank you for your interest in a clinical rotation at HCC of Rural Missouri and the Live Well Community Health Clinics.  Please fill out the following request form. 

The following forms are required ONCE YOUR REQUEST HAS BEEN APPROVED:

  • Student Registration From

  • Signed Confidentiality Form

  • HIPAA worksheet (attached presentation reviewed)

  • School Liability/Insurance Information

  • Immunization Schedule with TB

  • Background check from school (if available

 

Please submit all forms to Stephanie Taylor at stephanie@hccnetwork.org

Once approved, please complete the following forms and return to Stephanie Taylor, stephanie@hccnetwork.org

Call to talk with us today!

816-617-2353

VISIT US

Health Care Collaborative of Rural Missouri

825 S. Business Hwy 13

Lexington, MO 64067

Call:  816-617-2353

Fax: 660-251-0519