REQUIRED FORMS:

Please complete / sign all forms and forward to:

CA Northstate University
ATTN: College of Medicine Administration
Flichard Delosreyes, Clerkship Coordinator
9700 West Taron Drive, Elk Grove, CA 95757

!NEW!  Medical Students, please complete ALL the required forms below. Forms and immunizations are to be submitted prior to the start of the academic year, failure to do so will result in having no access to KP Systems. In addition, all forms must be submitted in the order of documents listed below and combined into a single PDF, failure to do so will result in being returned for resubmitting. 

!CONTINUING! Third Year Medical Students, please complete the only marked (*) forms. Forms and immunizations are to be submitted prior to the start of the academic year.

(click on each attestation to open the form)

1) Medical Student Registration Form

3) Fire and Safety Plan

4) Infection Control 

5) Drug Free Workplace-Employee Acknowledgement

(*) 6) Confidentiality Agreement

(*) 7) KP's Electronic Information Systems User Account/Confidentiality Agreement

(*) 8)  Pls. sign the Annual General Compliance Training after reading the Annual Compliance Guide