Name:Carla Nicole C.

Dairo
Email Address: ccdairo1274cab@student.fatima.edu.ph
Mobile No. :09266733792
Current Address : Palayan City

In 2019, the Coronavirus Disease (COVID -19) was declared as a global health crisis and the Philippines
was put in a state of public health emergency in 2009 in order to mitigate the transmission of the disease.

In the meantime, to ensure continuity of learning, the Commission on Higher Education (CHED)
mandated higher education institutions (HEIs) to shift to flexible learning. CHED Memorandum Order
(CMO) no.4, s. 2020 on "Guidelines on the Implementation of Flexible Learning” was issued for AY
2020-2021.

Flexible learning currently is the most appropriate and safest learning approach during this pandemic.
However, there are certain competencies in some programs where face to face instruction would be
necessary. As such, a well-planned, gradual and safe re-opening of campuses would be essential,
following strict protocols and guidelines as set forth by the CHED, IATF, DOH and in collaboration with
the local government units.

In a January 2021 meeting with CHED officials, higher education institutions were oriented on the
CHED- DOH Joint Memorandum Circular regarding Guidelines on the Gradual Reopening of
campuses of higher education institutions for limited face to face classes during the COVID-19
pandemic.

Cognizant of the need and based on the survey conducted among nursing students of Our Lady of
Fatima University wherein 74% of the students manifested willingness to undergo limited face to face
instruction for their Related Learning Experience, the University has embarked on retrofitting its
facilities as well as crafted a recalibrated learning continuity plan for nursing students.

As a student of Our Lady of Fatima University- College of Nursing, I have been oriented and duly
informed about the face-to-face guidelines, requirements and protocols of the University and its base
hospital.

As such I voluntarily give this informed consent and signify my willingness to participate in the limited
face to face of our Related Learning Experience and abide by all the health protocols as mandated by
the university.

Parent’s Signature over Printed Name Date :Sept.05,2022

 Students' Health Requirements for Face-to-face Classes/ Internship

An OLFU student will only be allowed to physically attend his/her classes/internship after satisfying the
following:

A.1
Must be 20 years old and above.
A.2 Must have submitted the filled-out OLFU Health Assessment Form with no identified
comorbidities.
A.3
Must be a member of PhilHealth with updated payments.
A.4 Must submit the signed informed consent form, both from him/her as a student and one
from his/her parent or guardian to the coordinator and an e-copy to the registrar.
A.5 Must have a copy of proof of completion of required vaccines (e.g., Annual Flu vaccine when
available, Hep vaccine, Pneumococcal vaccine etc. and depending on the program
he/she is enrolled in).
A.6 Must have a copy of the negative result of RT-PCR test taken within 5 days prior to the start of
clerkship and submitted to the coordinator at least 3 days before the start of rotation. A.7 Must
download the contact tracing app required by the Local Government Unit and the StaySafe app.
A.8
Must also have the required University contact tracing app.
A.9 Must have sets of Personal Protective Equipment (PPE) that will be worn during the
internship.

Parent’s Signature over Printed Name Date :Sept.05,2022

Students' Health Requirements for Face-to-face Classes/ Internship

An OLFU student will only be allowed to physically attend his/her classes/internship after satisfying the
following:

A.1
Must be 20 years old and above.
A.2 Must have submitted the filled-out OLFU Health Assessment Form with no identified
comorbidities.
A.3
Must be a member of PhilHealth with updated payments.
A.4 Must submit the signed informed consent form, both from him/her as a student and one
from his/her parent or guardian to the coordinator and an e-copy to the registrar.
A.5 Must have a copy of proof of completion of required vaccines (e.g., Annual Flu vaccine when
available, Hep vaccine, Pneumococcal vaccine etc. and depending on the program
he/she is enrolled in).
A.6 Must have a copy of the negative result of RT-PCR test taken within 5 days prior to the start of
clerkship and submitted to the coordinator at least 3 days before the start of rotation. A.7 Must
download the contact tracing app required by the Local Government Unit and the StaySafe app.
A.8
Must also have the required University contact tracing app.
A.9 Must have sets of Personal Protective Equipment (PPE) that will be worn during the
internship.