now accepting applications for our nurse practitioner

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Now Accepting Applications for Our Nurse Practitioner Residency in Community Health and Primary Care Training the Next Generation of APRNs in Integrated Primary Health Care Waianae Coast Comprehensive Health Center (WCCHC) is pleased to announce that it is accepting applications for the Nurse Practitioner Residency Program in Primary Care and Community Health. The class of 2021-2022 will begin August 2 021 . Application deadline is April 1 , 2021. WCCHC is committed to leadership, transformation and innovation in health care. This residency is designed for new nurse practitioners with a commitment to developing career practices in the challenging setting of the FQHC and/or special populations. The Nurse Practitioner Residency in Primary Care and Community Health has the following goals: EXPAND access to quality primary care for underserved and special populations and contribute to the clinical workforce by training new nurse practitioners in an integrated community healthcare setting. STRENGTHEN health care access through telehealth for Native Hawaiian and Pacific Islander communities that Waianae Coast Comprehensive Health Center serves. PROVIDE health care services with cultural humility and increased knowledge of Hawaiian cultural traditions and practices that influence the WCCHC population’s health choices. DEVELOP broader access to treatment of common behavioral health conditions and holistic addiction/pain management in a primary care setting on the West Coast of Oahu. IMPROVE population health of the Waianae coast through the NP Residency’s WCCHC Quality Improvement Program. INCREASE the number of Advanced Practice Registered Nurses (APRN) who have completed preceptor training in the State of Hawaii. 1. Completed Application 2. CV 3. Copy of Hawaii RN and APRN License 4. ANCC/AANP Certification 5. Three (3) letters of recommendation. Please see below for specifics. If you have any questions or difficulties, please email [email protected] Application Requirements:

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Page 1: Now Accepting Applications for Our Nurse Practitioner

Now Accepting Applications for Our Nurse Practitioner Residency

in Community Health and Primary Care Training the Next Generation of APRNs in Integrated Primary Health Care

Waianae Coast Comprehensive Health Center (WCCHC) is pleased to announce that it is accepting applications

for the Nurse Practitioner Residency Program in Primary Care and Community Health.

The class of 2021-2022 will begin August 2 021. Application deadline is April 1, 2021.

WCCHC is committed to leadership, transformation and innovation in health care. This residency is designed for new nurse practitioners with a commitment to developing career practices in the challenging setting of the FQHC and/or special populations.

The Nurse Practitioner Residency in Primary Care and Community Health has the following goals:

• EXPAND access to quality primary care for underserved and special populations and contribute to the clinical workforce by training new nurse practitioners in an integrated community healthcare setting.

• STRENGTHEN health care access through telehealth for Native Hawaiian and Pacific Islander communities that Waianae Coast Comprehensive Health Center serves.

• PROVIDE health care services with cultural humility and increased knowledge of Hawaiian cultural traditions and practices that influence the WCCHC population’s health choices.

• DEVELOP broader access to treatment of common behavioral health conditions and holistic addiction/pain management in a primary care setting on the West Coast of Oahu.

• IMPROVE population health of the Waianae coast through the NP Residency’s WCCHC Quality Improvement Program.

• INCREASE the number of Advanced Practice Registered Nurses (APRN) who have completed preceptor training in the State of Hawaii.

1. Completed Application

2. CV

3. Copy of Hawaii RN and APRN License

4. ANCC/AANP Certification

5. Three (3) letters of recommendation. Please see below for specifics.

If you have any questions or difficulties, please email [email protected]

Application Requirements:

Page 2: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

General Information Please complete all relevant fields.

First Name Middle Name Last Name Suffix

( ) -

Contact Email Address Cell Phone Home Phone 

Male: Female:

Home Address Please enter your home address in full.

State: Zip:

Home Address Line 1:

Home Address Line 2:

City:

Other First Name Other Middle Name Other Last Name From Date  (mm/yy) To Date  (mm/yy)

Other First Name Other Middle Name Other Last Name From Date (mm/yy) To Date  (mm/yy)

For Non U.S. CitizensPlease provide information on your immigration status.

Country or Citizenship Visa Visa Number Visa Date

Language(s)Please list all non-English languages spoken and level of fluency. 

Fluency:

Fluency:

Fluency:

Language 1:

Language 2:

Language 3:

( ) -

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Ethnicity (Optional):
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Birth Place:
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Gender:
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Please enter any other names by which you have been known including those appearing on professional diploma and licensure.
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Other Names
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Page 3: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Education List undergraduate, graduate and professional education below.

State: Zip:

Fax: Country:

Education Type:

Degree Earned:

Institution Name:

Address Line 1:

Address Line 2:

City:

Phone:

From (mm/yy):  To: (mm/yy):

State: Zip:

Fax: Country:

Education Type:

Degree Earned:

Institution Name:

Address Line 1:

Address Line 2:

City:

Phone:

From (mm/yy):  To: (mm/yy):

State: Zip:

Fax: Country:

Education Type:

Degree Earned:

Institution Name:

Address Line 1:

Address Line 2:

City:

Phone:

From (mm/yy):  To:  (mm/yy):

Page 4: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Professional Reference/Letters of Recommendation Letters of recommendation should come from the professional references listed below. Examples include:

Professional Reference

Reference Type: Name:

Institution/Relationship: Specialty:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone: Fax:

Email:

Professional Reference

Reference Type:Name:

Institution/Relationship: Specialty:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone: Fax:

Email:

Professional Reference 

Reference Type:Name:

Institution/Relationship: Specialty:

Address Line 1:

Address Line 2:

City: State: Zip:

Contact Phone: Fax:

Email:

( ) -( ) -

( ) -( ) -

( ) -( ) -

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Program Director, Department Chair or Faculty from your graduate program
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Director/supervisor from most recent employment
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Professional Reference—preferably a manager that has knowledge of your clinical competence
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Page 5: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Application Attestation I attest that all information provided in this Application is true and complete to the best of my knowledge and belief. I will notify the  Organizations  and/or  their  agents  within  10  days  of  any  material  changes  to  the  information  I  have  provided  in  my  application or authorized to be released pursuant to the credentialing process. I understand that corrections to the application are permitted at any time prior to a determination of membership and/or privileges or affiliation by the Organizations, and must be submitted on-line or in writing, and must be dated and signed by me.

Electronic Signature – Type full name Last 4 digits of SSN Date

Page 6: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Essay Question

Please submit responses to the following question. This is an opportunity to reflect upon and communicate to WCCHC

your personal statement of qualifications, interest, and motivation in acceptance to this Residency. Additional space is

available at the end of this application.

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A. What personal, professional, educational and/or clinical experiences have led you to choose the role of a primary care nurse practitioner in a community health setting? Perhaps you can share your experience working with underserved populations.
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Page 7: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Essay Question

Please submit responses to the following question. This is an opportunity to reflect upon and communicate to WCCHC your

personal statement of qualifications, interest, and motivation in acceptance to this Residency. Additional space is available at the

end of this application.

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B. When considering your career development, what are your long and short term goals?
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Page 8: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Essay Question

Please submit responses to the following question. This is an opportunity to reflect upon and communicate to WCCHC your

personal statement of qualifications, interest, and motivation in acceptance to this Residency. Additional space is available at the

end of this application.

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C. Please tell us how you relate to the WCCHC mission statement.
Page 9: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Essay Question

Please submit responses to the following question. This is an opportunity to reflect upon and communicate to WCCHC

your personal statement of qualifications, interest, and motivation in acceptance to this Residency. Additional space is

available at the end of this application.

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D. The WCCHC Residency for Nurse Practitioners will require the residency class to interact and collaborate as a group. Please comment on your personal qualities and strengths that you think will contribute positively to this program.
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Page 10: Now Accepting Applications for Our Nurse Practitioner

APRN Residency Program Application

Essay ___________________

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Essay Question
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Use this additional space to continue your essay. Please indicate Essay Question A, B, C, or D.
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APRN Residency Program Application

Essay ___________________

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Use this additional space to continue your essay. Please indicate Essay Question A, B, C, or D.
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APRN Residency Program Application

Essay ___________________

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Use this additional space to continue your essay. Please indicate Essay Question A, B, C, or D.
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APRN Residency Program Application

Essay ___________________

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Use this additional space to continue your essay. Please indicate Essay Question A, B, C, or D.
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Essay Question