Students are responsible for finding and securing their placements within Galen Medical Group. It is highly encouraged that you work with your school coordinator to find a placement location, as they have likely helped other students from your school find placements in the past. Please print and have your Clinical Coordinator fill out your placement  information via the form below (all Galen locations are included). Once you have your form completed, click the “Submit Application” button below and upload this document with your application. 

• Externship Application Form

Verify Affiliation Agreement 

A student must be affiliated with an educational institution and collect credits/units for an externship. Affiliation agreements between Galen Medical Group and potential externs home school are required to protect the liability of Galen Medical group. Since externships are traditionally unpaid experience that allows students to get credit for their work, the student’s college must take legal responsibility for the student’s conduct during their externship at Galen Medical Group locations. 

Please review the Affiliation Agreements Database linked below for a list of active affiliation agreements. If your school is not listed, please request from your school coordinator an affiliation agreement to be sent to training@galenmedical.com for review and approval.  

• Affiliation Agreement Database

Medical Clearance Form

Medical clearance is required for all students that want to extern at Galen Medical Group. Most schools have these records for students and can be attested to on your “Externship Application”. Medical clearance can also be obtained by the student’s primary care physician. Students without primary care physicians may have their vaccination information verified by the medical professional at their school hospital or clinic. 

All areas of the Outside Clearance form are required to be completed with dates for this form to be considered complete. You must submit your completed Externship Clearance form with your externship packet unless completed by your school on the “Externship Application”. 

Hep B: Hepatitis B is a series of vaccinations that could take up to 6 months to complete. If the student is not vaccinated prior to the expected start date, Galen may choose to enter into an agreement by both parties signing the Hep B Vaccination Agreement. 

• Medical Clearance Form
• Hep B: Vaccination Agreement 

Mandatory Training 

Students are required to follow all policies while completing their externship with Galen. Please review Galen’s employee handbook and compliance program prior to your externship start date.

• Compliance Handbook
• Employee Handbook

Background Check 

Galen requires all students to have had a background check to include Medicare and Medicaid exclusion screening and negative drug screen as part of ensuring Galen safety and compliance. If background checks and drug screening are completed by your affiliated school, please have your school certify this on the “Externship Application” unless otherwise stated in the clinical Affiliation Agreement. 

Security Request

Galen requires all students to fill out an EMR Security Access form to gain access to our electronic medical records system. This form will be completed after you submit your application.

Submit Application 

Submit your Externship Program Application for review below: if you are having trouble submitting your application, please email training@galenmedical.com.