Nursing students and instructors may download required security forms for accessing Memorial Hospital’s electronic medical record (EMR).
Important: Submit all forms at least three weeks prior to the student’s clinical start date. Failure to do so may lead to delayed access and inability to electronically document patient care. Please contact Nicole Dickey, Nursing Educator, at 574.647.7228 for more information.
Instructors, please download and complete the nursing school activity worksheet. Remember to provide all required fields in their entirety (including the last four digits of the student’s Social Security number and full birth date). Please email the completed worksheet to Beacon’s Information Systems Security Team (InformationSecurity@BeaconHealthSystem.org) and Nicole Dickey (ndickey@BeaconHealthSystem.org).
Each student and instructor must print and sign the Confidentiality and Nondisclosure Agreement. The form may be faxed to 574.647.3062.
User account and passwords
Reset your password using the Self-Service Password Reset Portal.