Websites of Interest
Departmental Internships
Student Responsibility Related to Internships
Students requesting internships at Upstate Medical University are responsible for directly contacting the department where they would like to intern.
Department Responsibility Related to Internships
The department hosting an intern will need to verify with the Contracts Office (464-4680), that an affiliation agreement between the student's school and SUNY Upstate Medical University exists. Once this is confirmed, the below forms and education will need to be completed by the intern.
Required Forms
- Risk Release Form
Read, sign, and date. If under 18 years of age, a parent or legal guardian must sign this form. - Confidentiality Agreement

- HIPAA Privacy Rule Education
and Completion Certificate
- ID Badge: All Self-Serve non-employee badge requests will be handled by Employee Health Service ensuring those requiring health clearance are properly cleared. Once a request for a non-employee badge is submitted via Self Serve the manager hosting the intern will be instructed via e-mail to have the new intern report to either Employee Health Service for clearance or to Payroll for badging. This new enhancement will help ensure Upstate's compliance with Department of Health regulations. For information, call Sandra Delaney in Payroll Services at 4-4840.
Health Statements
- Detailed Health Statement

(Individual who will be at SUNY Upstate greater than 3, but less than 30 days) - Short Term Health Statement
(Individual who will be at SUNY Upstate 3 days or less) - Certificate of Health Statement
(Individuals who will be at Upstate 30 days or more)
Requirements
- The initiating department will be responsible to maintain documentation of required forms and forward copy to appropriate department.
- Guidance Counselor or Partners in Business, or a sponsoring department must assist with placement and ensure forms are submitted and HIPAA self study is complete.
- Student must be minimum of 15 years old *(Pediatrics In-Patient Child Life Specialist—learner must be at least 18 years old).
