Merced College. Diagnostic Medical Sonography Program. Admission Policies, Procedures & Application Forms

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1 Merced College Diagnostic Medical Sonography Program Admission Policies, Procedures & Application Forms revised: October 2015 You may not use old or outdated applications/forms. Only the application in this packet will be accepted, absolutely no exceptions. T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 1 revised: April 20, 2016

2 Merced College Diagnostic Medical Sonography Program Admission Policies & Procedures Submit your COMPLETED application packet to the Allied Health Office IN PERSON ONLY. Mailed, faxed or ed applications will NOT be accepted! Upon submission of a completed application, the date and time received will be stamped on the application. After your records have been verified, that date and time will become your official application date. You will receive a notice in the mail advising you of the following: - you meet the Entrance Requirements and Prerequisites - your official application date & time, and - your number on the enrollment list. If you do not meet all the application requirements, your application will be returned nullifying any application receipt date. Enrollment will be based on a first-come, first-serve basis with the first eight to ten QUALIFYING applicants allowed to enroll for the class beginning August T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 2 revised: April 20, 2016

3 Merced College Diagnostic Medical Sonography Program Program Costs Legal residents of the State of California are required to pay nominal fees. In addition, students may expect other miscellaneous fees and expenses during the length of the program. (Non-Resident tuition fee: $173 per unit, plus enrollment fee) Fees Enrollment/Tuition Fee (entire program 49 units x $46/unit) $2,254 Contact admissions and records for details. Fees subject to change as per the State Legislature Health Fee (entire program) $79 Parking ($20 x 4 semesters; $10 x 1 summer) $90 Additional Expenses CPR Certification $60 Physical & Immunizations $300 Uniforms $180 Books (entire program) $1,500 Background Clearance & Drug Screening $90 Licensing ARDMS (Physics) $200 ARDMS (Obstetrics/Gynecology) $250 ARDMS (Abdomen) $250 Fees are subject to change at anytime Total $5,253 T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 3 revised: April 20, 2016

4 Merced College Diagnostic Medical Sonography Program Name: Read all information contained in this packet carefully before submitting your application. Submit application & pertinent documents to the Allied Health Office (room 126) IN PERSON ONLY. Mailed, faxed or ed applications will NOT be accepted! *New and Returning Students will be required to apply for college admission and complete appropriate registration procedures, and obtain a Student I.D. number and card. Further Registration information is available online: (click on the Admission & Aid button on the home page, then select How to Apply ) Application Forms/Check-Off Sheet Your application must include the following (if applicable). Place all documents in the order as stated below: Check-Off Sheet (this form) Application Copy of your professional license(s) - if applicable Official Transcript verifying your Bachelor s of Science Degree - if applicable Program Prerequisites - Equivalency Check-off Sheet - if applicable In-Process Prerequisite Course Form - if applicable Unofficial Transcript from Merced College - Transcript must be printed from the Admissions & Records Office - No Exceptions - if applicable Official Transcript(s) from other colleges - if applicable Transcript Request Form Understanding of Program Regulations Form Hospital-based Patient Care Experience Forms- if applicable Enrollment List/Status Report Self Addressed Stamped Envelope T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 4 revised: April 20, 2016

5 Merced College Allied Health Division Diagnostic Medical Sonography Program Application Date: Initials: For Office Use ONLY Complete Application received on: Time: GPA Print Clearly Last Name First Name M.I. Former (Maiden, Other) Mailing Address City State Zip Date of Birth Soc. Sec. No. or ITIN (Individual Taxpayer Identification No.) MC Student ID No. Telephone #(s) Gender Female Male Ethnicity Completion of Prerequisite Courses ALLH-67 Medical Terminology Prerequisite College/University Course Name & Number Unit Value Grade Semester & Year BIOL-16 General Human Anatomy BIOL-18 Principles of Physiology ENGL-1A College Composition & Reading or COMM-01 MATH-26 College Algebra for Liberal Arts (or equivalent) PHYS-10 Concepts in Physics or RADT-13A Professional Licence(s) - College/University/Year Completed - You must attach a copy of your licence(s) OR Bachelor s of Science in Biological Science College/University/Year Completed - You must attach Official Transcript verifying your degree. I certify that all information provided in connection with this application is true, correct and complete. Providing false information or omitting required information is fraud and grounds for denial of enrollment or immediate expulsion from the Program. Date Signature T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 5 revised: April 20, 2016

6 Program Prerequisites - Equivalency Check-Off Sheet For students who have completed program requirements from a school other than Merced College, courses must be checked and initialed for equivalency by a Merced College Allied Health Counselor prior to submitting application. All program prerequisites must be passed with a grade of C or better and combined GPA of 2.35 or higher. Sealed official transcripts must be attached verifying prerequisites have been met. Prerequisite College/ University Course Name & Course Number Grade Unit value Semester & year Counselor Initial verifying equivalency ALLH-67 Medical Terminology BIOL-16 General Human Anatomy BIOL-18 Principles of Physiology ENGL-1A College Composition & Reading or COMM-01 Fundamentals of Speech MATH-26 College Algebra for Liberal Arts (or equivalent math course) PHYS-10 Concepts in Physics or RADT-13A Radiologic Sciences I It has been determined that the above course(s) are equivalent. Merced College Allied Health Counselor: Print Name Signature Date T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 6 revised: April 20, 2016

7 Diagnostic Medical Sonography Program In-Process Prerequisite Course Form I, am currently enrolled in the following Program Prerequisite Course(s) this semester, Spring Upon completion of the semester, I will provide a transcript verifying completion of the course with a C or better. I am also responsible to ensure equivalency of my course(s). I understand that if I fail the course(s) listed below, my application becomes null and void. Date Signature Prerequisite College/University Course Name & Course Number Unofficial Grade Unit value Signature of Professor(s), Current Date & Business Card must be attached - No Exceptions ALLH-67 Medical Terminology BIOL-16 General Human Anatomy BIOL-18 Principles of Physiology ENGL-1A College Composition & Reading or COMM-01 MATH-26 College Algebra for Liberal Arts (or equivalent math course) PHYS-10 Concepts in Physics or RADT-13A Radiologic Sciences I Attach Business Card(s) T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 7 revised: April 20, 2016

8 Transcript Request NOTE: All students must submit this form Last Name First Name Middle Name Former Names (Maiden, Other) Social Security No. MC Student ID. No. Did you attend Merced College before 1986 Yes No Date Signature T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 8 revised: April 20, 2016

9 Understanding of Program Regulations Name (print) I understand Merced College reserves the right to revise enrollment requirements, Program Prerequisites and/or Selection Procedures at ANYTIME. I understand it is my responsibility to meet enrollment requirements, program prerequisites, ensure equivalency, follow proper application procedures, provide transcripts and keep informed on revisions regarding the program. I understand that if I submit an application packet that is incomplete, or does not meet enrollment requirements, program prerequisites/application requirements, it will be returned to me with an explanation of why it was returned and the date of submission of my application becomes null and void. I understand that after my application is accepted and verified, it is my responsibility to notify the Allied Health Office of any changes in address and/or telephone number. I understand that if I am admitted into the program, failure to notify the Allied Health Office with a "Confirmation of Acceptance" in the allotted time prescribed constitutes grounds to assign my position to an alternate. I understand that if I am admitted into the program and I must decline acceptance, my slot will go to the next student on the enrollment list. I understand that if I withdraw or am dismissed from the program, I will no longer be eligible for readmittance into the program. Date Signature Date Authorized Allied Health Personnel T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 9 revised: April 20, 2016

10 Diagnostic Medical Sonography Program Hospital-based Patient Care Experience Name of Prospective Student: Name of Hospital: Address of Hospital: Direct Phone # of Supervisor: Month(s) &Year(s) of Service: From: To: Evaluation of Student on next page T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 10 revised: April 20, 2016

11 Diagnostic Medical Sonography Program Hospital-based Patient Care Experience Supervisor - Only sign and evaluate student if he/she has completed 500 hours or more of Hospital-based Patience Care Experience (paid and/or volunteer experience is acceptable) Evaluation of Student Supervisor - place an X in the box which best describes the performance of Employee and/or Volunteer Exceptional Satisfactory Needs Improvement Hospital bed and wheelchair patient transportation; ability to safely transfer patients on/off scanning tables; application of personal body mechanics Discuss the use, and care for intravenous lines, catheters, percutaneous drains, ET tubes, and oxygen administration devices Maintain infection control and utilize standard (universal) precautions; bloodborne pathogen protection; ability to properly manage bodily fluids; management, and proper disposal of contaminated and biohazard materials; proper hand washing techniques; isolation precautions Discuss appropriate responses to condition-specific medical emergencies; request assistance with life-threatening situations Ability to effectively communicate (oral, written and non-verbal) with all hospital stakeholders Knowledge of Medical Imaging Department ALARA principles; shadow in the Imaging / Sonography Department(s) Working knowledge of patient confidentiality/ HIPAA; patient identification procedures Ability to perform blood pressure Comments (you may attach a separate sheet if necessary): Supervisor s Name: Supervisor s Signature: Date: Attach Business Card T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 11 revised: April 20, 2016

12 Diagnostic Medical Sonography Program Enrollment List/Status Report Name: As of this date: Your application, transcripts and supporting documentation have been reviewed and verified. You are therefore qualified to be on the Enrollment List for the class beginning August Your number on the Enrollment List is: Your official application date & time is: Your GPA is: Enrollment will be based on a first-come, first-serve basis with the first eight to ten QUALIFYING students allowed to enroll. You will be notified in 3-4 weeks of your acceptance into the program. Notify this office as soon as possible if you have changed your plans and no longer wish to remain eligible for entry into the program. If you have any questions contact the Allied Health Office at or T:\Sonography\Sono Application & Acceptance Letters\General Application\Sono Application-.wpd 12 revised: April 20, 2016

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