Now Accepting Applications for: Community Health & Primary Care Nurse Practitioner Residency

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1 Growing the next generation of primary care providers Now Accepting Applications for: Community Health & Primary Care Nurse Practitioner Residency CHC s Community Health & Primary Care s mission is to train up highly effective, competent, & autonomous inter-professional primary care providers in the FQHC setting. Our goal for new graduate Family Nurse Practitioners is to provide with the depth, breadth, volume & intensity of clinical training necessary to serve as primary care providers in the complex setting of the country s health care safety net. Criteria: Registered Nurse license with at least 3 years experience. Graduate of Master s or Doctoral Graduate Nurse program in good standing. Family Practice board certification eligibility confirmed with estimated test date. Washington state ARNP licensure eligible. Federal DEA certificate eligible. Written commitment to practice as a primary care provider in a Federal Qualified Health Center. Bilingual preferred Application Requirements: CV (must show five year work history) Please submit essay responses to the following questions. This is an opportunity to reflect upon and communicate to CHC your personal statement of qualifications, interest, and motivation in acceptance to this Residency. 1. What personal, professional, educational and clinical experiences have led you to choose nursing as a profession, and the role of a family nurse practitioner as a specialty practice? What are your aspirations for a Residency program? Please 1 P a g e

2 comment upon your vision and planning for your short and long-term career development. 2. What are the goals that you are looking to accomplish during your residency at CHC? Please identify specific areas of interest by lifecycle, age, or setting that you would like to develop increased mastery, competence or confidence in. 3. CHC s Residency is a unique Inter-Professional Residency with physicians, nurse practitioners, dentists & pharmacists learning and working alongside each other. The first classes of residents will be, in essence, co-creators of this program. Please comment on your personal qualities and strengths that you think will contribute positively to this experience. What apprehensions, concerns, and hesitations might you have? Please feel free to be straightforward! Headshot photo (used for identification purposes only) Please submit three letters of reference. Letters should include: 1. 1 letter from either an employer or clinical preceptor letter from an advisor/np Faculty/Program Director providing a brief assessment of your capabilities for this Residency letter from the Associate Dean indicating your cumulative GPA, academic standing and verifying graduation criteria will be fulfilled by June 13, Please have the reference letters mailed directly to you with a designated seal as indicated by a sealed envelope taped, and signature across the taped back flap by the individual providing the reference. 2 P a g e

3 Application for Community Health & Primary Care Nurse Practitioner Residency Name: Last First Middle DEGREE Phone: ( ) - (preferred) ( ) - (alternate) Years of RN experience: Graduate University: Proficient Language(s): CLINICAL ROTATIONS/FELLOWSHIPS/PRECEPTORSHIPS List in chronological order include month/year of attendance, clinical hours, full mailing address of clinical institution & preceptor/attending provider s name/title. (Attach additional page if needed) Clinical Institution: Clinical Institution: 3 P a g e

4 Clinical Institution: Clinical Institution: POST GRADUATION/BOARD CERTIFICATION STATUS 1. Are you currently in good academic standing & expect to graduate on time? Y/N 2. What is your expected date of graduation? DATE: / / 3. Have you been accepted to the Certification Body to take the FNP boards? Y/N 4. What is your expected date of board certification? DATE: / / 5. Are you available to live & work in the Tacoma/Pierce County area for an intense oneyear professional residency? Y/N 6. Are you willing to practice as a primary care provider in a FQHC? Y/N Other Certifications & Memberships Please note all professional certifications (ACLS, PALS, etc) and any memberships to professional societies, etc Areas of Interest/Specialty: (Primary)/ (Secondary) 4 P a g e

5 Permission to Release Information I,, give permission to (clinical supervisor, faculty member, advisor, associate dean, or chair/program director to provide information about me for the purposes of a reference letter for the application to the Community Health & Primary Care NURSE PRACTITIONER Residency. Signature Date (Please make appropriate copies of this page & distribute as needed) 5 P a g e

6 Please attach all required documentation to support your residency application in the order listed below. Applications due/received by April 1, o Application o CV o Residency essays o Copy of Registered Nurse License o Copy of ARNP License (if already available) o Written confirmation of eligibility of NP program graduation o ANCC/AANP certification or evidence of eligibility for certification o Three letters of reference o Headshot photo (used for identification purposes only) Community Health Care NURSE PRACTITIONER RESIDENCY Attn: Residency Program Coordinator 1202 MLK Jr. Way Tacoma, Washington Please npresidency@commhealth.org or call for any questions. Thank you for applying to CHC s Community Health & Primary Care NURSE PRACTITIONER Residency. Proud to be partnered with 6 P a g e