Oregon Coast Community College Medical Assistant Program Application Academic Year Deadline: December 4, 2015

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1 Oregon Coast Community College Medical Assistant Program Application Academic Year Deadline: December 4, 2015 Program Description The Oregon Coast Community College Medical Assistant Program is a four (4) term program that prepares students for entry level employment in a physician's clinic or a variety of other healthcare settings. Program graduates will have the academic, administrative and clinical skills necessary for an allied healthcare professional. Courses cover anatomy, physiology, and medical terminology, as well as, computers, office procedures, communications, psychology and mathematics. Overview of the Role of Medical Assistants Perform administrative and clinical duties under the direction of a physician or other medical practitioner. Administrative duties may include scheduling appointments, keeping medical records, billing, and insurance coding. Employers look for candidates who can demonstrate they have the qualities necessary for success in the medical assistant field including candidates who: Can think critically, solve problems and construct practical solutions Have excellent interpersonal, written and verbal communication skills Are nonjudgmental about the diverse populations of people Are service oriented Have the abilities for social perceptiveness Intended Program Learning Outcomes: Upon completion of the Medical Assistant Training Program students will have the resources to: 1. Interact in a caring and respectful manner with patients, families, and the health care team. 2. Establish and manage office procedures and implement medical documentation systems using appropriate medical terminology. 3. Perform the administrative business tasks required in a medical office. 4. Assist the physician and other members of the health care team in clinical procedures related to the examination and treatment of patients. 5. Comply with quality assurance requirements in performing clinical laboratory procedures. 6. Perform common diagnostic procedures under a licensed health care provider to ensure patient comfort and safety.

2 Certificate in Medical Assistant Requirements: PROGRAM PREREQUISITES: Course No. Cr. Placement into Writing 121 or completion of WR 115 with a C or better. Placement into Reading 120 or completion of Reading 115 with a C or better. Placement into Math 20 or higher. GENERAL EDUCATION COURSES Course No. Cr. English Composition (or higher) WR Psychology of Human Relations PSY REQUIRED MAJOR COURSES Course No. Cr. Body Structures & Function 1 NCMA Medical Assistant Clinical Procedures 1 NCMA Office Skills for the-he Medical Office NCMA Body Structures & Functions 2 NCMA Medical Assistant Clinical Procedures 2 NCMA Medical Assistant Practicum 1 NCMA Medical Assistant Practicum 2 NCMA Pharmacology for Medical Assistants NCMA All required courses must be completed with a C grade or higher to receive the degree. Eligibility & General Information Application Deadline for Winter 2016 is December 4, Application Process Step 1. Read through the entire application packet. Step 2. Go to the OCCC College Website: Medical Assistant and read: The Disqualifying Crimes and Potentially Disqualifying Crimes lists Step 3. Complete an OCCC online admissions form, if not currently enrolled or you have not been a student here in the last five years as an OCCC Step 4. Come to Oregon Coast Community College to take the Compass Placement test. Information on the Placement test is located at the end of this application. See above for pre-requisites Step 5. Meet with an academic advisor at Oregon Coast Community College Step 6. Complete the application form, including the signed Agreement Form. Step 7. Set up an account with Complio through American DataBank for uploading documentation on required immunizations, TB test, and CPR training. (Please see documents at the end of this application package.) Step 8. Complete a Criminal Background Check between November 1, 2015 and December 1, 2015 at: Results will be communicated directly to us.

3 Step 9. Drug Screening must be completed November 1, 2015 and December 1, 2015, at Samaritan Health Services Occupational Medicine located at 775 SW 9 th St., Suite E, in Newport. No appointment is needed. Their phone number is Hours are 8:00-11:30 and 1:00-4:30. Results will be communicated directly to us. Once you complete a criminal background (CBC), American DataBank will send you a form to take with you to Samaritan Health Services, Occupational Medicine for the drug screening. Associated Program Costs (Responsibility of the applicant/student) Students will also need to provide the following for use in these trainings: Students are responsible for the cost of the criminal background check (CBC) and drug screen (UA) obtaining immunizations, TB testing, CPR training and setting up an account with Complio through American Data Bank. Tuition and Fees: Standard OCCC tuition and fees apply. This program is financial aid eligible but you must see an academic advisor and set up an academic plan. You will also need to complete a (FAFSA application) Free Application for Federal Student for Students are required to have Burgundy Scrubs and white or black shoes with rubber soles and minimal markings. These items need to be available the first week of Fall Term. Textbook(s) per course: available through My College Store at OCCC. A skills lab bag is required for the clinical procedure course and is available through My College Store at OCCC. For more information please call

4 MEDICAL ASSISTANT CERTIFICATE CURRICULUM MAP One Year Medical Assistant Certificate Fall Term 2015 Winter Term 2016 Spring Term 2016 Summer Term 2016 Course Number Course Title CR Course Number Course Title CR Course Number Course Title C R Course Number Course Title NCMA 101 NCMA 102 NCMA 103 Body Structure and Function I Medical Assistant Clinical Procedures I Office Skills for the Medical Office 4 NCMA NCMA WR 121 Body Structure and Function II Medical Assistant Clinical Procedures II English Composition or Psychology and Human Relations 4 NCMA 113 Medical Assistant Practicum I 4 NCMA 125 Pharmacology for Medical Assistants 4 WR 121 English Composition or Psychology and Human Relations PSY 101 PSY Total Medical Assistant Credits: 33 4 NCMA Medical Assistant Practicum II Pre-Requisites Placement in Writing 121 or completion of WR 115 with a C or better Placement into Reading 120 or completion of Reading 115 with a C or better Placement in Math 20 or higher Co-Requisites Course Number Course Title Credits PSY 101 Psychology and Human 4 Relations WR 121 English Composition 4 Total Certificate Credits 41

5 Oregon Coast Community College Medical Assistant Program The following must be completed as part of the application process: Complete application. Signed Acknowledgement and Agreement Form. Attach Compass Placement Test results or college transcripts Things to do: Complete the OCCC online admissions form if you are not a current student or have not taken classes within the last year of this application. Complete a FAFSA application for Make an appointment with an academic advisor at OCCC. Read the disqualifying and potentially disqualifying crimes document. Complete a background check and drug screen after November 1, 2015 but before December 1, Set up an account with Complio through American DataBank for submission of immunizations, TB testing and CPR training. 5

6 Oregon Coast Community College Medical Assistant Application Form Instructions 1. Please complete all forms, typing or printing clearly in black ink 2. All requested attachments are required and must be submitted with the application 3. Please submit your application during the application period for the term in which you wish to attend. 4. Incomplete applications will not be processed. Applicant Information Complete this section by filling in all blanks. If not applicable, indicate n/a. An inability to contact you will result in closure of the application process and re-application will be necessary. Today s Date: Applicant s Full Legal Name: Past Legal Names: Social Security #: Mailing Address: Birthdate: PO Box or Number and Street Apt/Lot # City State Zip OCCC ID # PCC G # PCC Phone Number: Work Phone Number: Cell Phone Number: Oregon resident for more than 90 days? Yes No Do you hold a high school diploma or GED? Yes No Date Received and Name of School: Will you need any reasonable accommodations to perform the essential functions of the class? If yes, please explain: Yes No 1. What is your understanding of the role of the Medical Assistant?

7 I certify that the above information is thorough and accurate to the best of my knowledge. Applicant Signature: Date: Printed Name

8 Medical Assistant Program Acknowledgement and Agreement Form Please Read the Following Carefully Before Signing I certify that the information set forth by my signature in this Application is true, complete, and accurate to the best of my knowledge. I understand that falsified statements on this application shall be considered sufficient cause for refusal of admission to the Oregon Coast Community College Medical Assistant Program I understand that acceptance into the program is dependent on successful completion of the admissions requirements and passing a criminal background check and drug screen.: I hereby release all parties and persons connected with any request for information from all claims, liabilities, and damages for whatever reasons arising out of furnishing such information. If these requirements are not met by the deadline given, I understand that OCCC has the right to drop me from the program and I am not eligible for a refund for any fees related to the class. Criminal History Requirements and Program Policies Participation in the Medical Assistant Program requires passing a criminal background check. My signature below indicates that I have read and understand the Oregon Department of Human Resources Lists of Potentially Disqualifying Crimes and Disqualifying Crimes. The document is available on the OCCC College Website: Medical Assistant I have read and understand the Medical Assistant Policy manual and agree to the policies outlined, including the technical standards for medical assisting available at the college website under Medical Assisting. Confidentiality Agreement Medical records and hospital information are confidential for the protection of patients, families, employees, medical staff, students/interns, and the hospital. Confidential information includes any information that a student hears or sees while conducting evaluation, research, or educational activities at any health care facility. Patient privacy is to be respected at all times. Breach of confidence is cause for immediate termination of the individual from the Medical Assistant Program. My signature below indicates the following: 1. I agree not to repeat or discuss, with any unauthorized individuals, confidential information, which I may see or hear in conducting evaluation, research, or educational activities while at any healthcare facility. 2. I agree not to obtain or distribute any originals or copies of any health care facilities documents that are considered confidential or part of a patient's medical record.

9 3. I understand that breach of confidence is cause for immediate termination of my enrollment in the OCCC Medical Assistant program. 4. I understand that unauthorized release of confidential information may subject me to civil liability under the provisions of state and federal laws. The address you provide will be our primary way of communicating with you throughout the application process. Please check your periodically to receive updates from us. Make sure that s from the college are not going to your spam folder. Providing your social security number is voluntary. If you provide it, the college will use your social security number for keeping records, doing research, aggregate reporting, extending credit and collecting debts. Your social security number will not be given to the general public. If you choose not to provide your social security number, you will not be denied any rights as a student. Once accepted, you will need to provide your social security number for a criminal background check for submission to the Oregon State Board of Nursing and for CASE grant managers. I certify that the above information is thorough and accurate to the best of my knowledge and that I understand and agree to comply with the disclosure statement. Applicant Signature: Date: Printed Name: Social Security or Student ID Number:

10 Oregon Coast Community College COMPASS Placement Assessment The COMPASS Placement Assessment is essential for proper placement in classes at Oregon Coast Community College in order to help ensure you have a successful college experience. The COMPASS Placement Assessment is required for: Anyone enrolling in an OCCC math and/or writing class who has not taken college level math within one year or college level writing within 5 years. Anyone enrolling in six or more credit hours in any single term. Anyone who does not possess a high school diploma or GED. Any High School junior or senior applying for the Expanded Options Program through their High School. COMPASS is an untimed, computerized test that helps your college evaluate your skills and place you into appropriate courses. COMPASS offers tests in writing, reading and math. Please bring a calculator with you for the math portion of the test. Pencils and scratch paper will be provided. You will receive your COMPASS test results immediately upon completion of testing and your score report will include placement messages informing you what course level you placed into. Plan to stay 2 to 3 hours. See sample test questions online at: Please plan on arriving 15 minutes early. The test fee is $ Occasionally it is necessary and/or beneficial for students to retest in a specific subject area. The fee for each retest in each subject area is $5.00. The testing/retesting fee may be paid prior to testing. Please bring your receipt, photo identification and Social Security number to the test session. The COMPASS test is necessary if you plan to apply for federal financial aid. Your social security number and identification are required to take the test and receive your scores. For testing in Newport, please schedule your test date and time by calling or For testing in Lincoln City please call ext SEATING IS LIMITED, SO RESERVATIONS ARE REQUIRED. ~ NO WALK-INS ACCEPTED LINCOLN CITY Call for current dates and times 3788 SE High School Drive NEWPORT 1:00 pm and 8:30 am 400 SE College Way For more information please call: (541) , or visit the website at

11 Oregon Coast Community College Health Form Student/Faculty Name: Program: These requirements are in place for the health and safety of students, faculty and their patients. By contract with your academic institution, all students and faculty participating in patient care experiences must meet the following health and safety requirements. The academic institution is responsible for ensuring that requirements have been met prior to participation in patient care/clinical experience. Records will be kept at the academic institution and random review by the clinical affiliates will occur on a regular basis. Documentation must meet requirements at all times. If you obtained your vaccine through an Oregon Public Health Department or through a school district in Oregon, after 1980 then you are probably in the ALERT system that is maintained by Public Health. Please call or visit your local Public Health Department as they may help you in obtaining the need documentation. SUBMITTED ONCE TUBERCULIN STATUS If no previous records or more than 12 months since last TST OR QuantiFERON (QFT) TB Gold test within 12 months OR If newly positive TST F/U by healthcare provider (chest X-ray, symptoms check and possible treatment documentation of absence of active M. TB disease) and need to complete health questionnaire If history of positive TST provide documentation of TST reading, provide proof of chest X-ray documenting absence of M. TB, medical treatment and negative symptom check OR If history of BCG vaccine QFT. If negative OK; If positive do Chest X-Ray, and symptom check by healthcare provider in 12 months HEPATITIS B Series of 3 vaccines completed at appropriate time intervals OR Provide documentation of positive titer (anti-hbs) OR If titer is negative or equivocal Proof of vaccinations (3 doses at appropriate intervals dated AFTER the titer) VARICELLA (Chicken Pox) Proof of vaccination (2 doses at appropriate intervals) OR Proof of immunity by titer or Physician documentation of proof of disease TETANUS,DIPTHERIA, PERTUSSIS (Tdap) Tdap required every 10 years OR Td (dated within the last 24 months) and Pertussis. CPR American Heart Association BCLS Healthcare Provider Certificate SUBMITTED EVERY YEAR TUBERCULIN STATUS Previously documented +TST results and prior negative chest X-ray results: submit annual symptom check completed within one year from healthcare provider. INFLUENZA Proof of annual vaccination(s)

12 Oregon Coast Community College Health Form Student/Faculty Name: Program: These requirements are in place for the health and safety of students, faculty and their patients. By contract with your academic institution, all students and faculty participating in patient care experiences must meet the following health and safety requirements. The academic institution is responsible for ensuring that requirements have been met prior to participation in patient care/clinical experience. Records will be kept at the academic institution and random review by the clinical affiliates will occur on a regular basis. Documentation must meet requirements at all times. Required immunizations must include mm/dd/yyyy if available. If you obtained your vaccine through an Oregon Public Health Department or through a school district in Oregon, after 1980 then you are probably in the ALERT system that is maintained by Public Health. Please call or visit your local Public Health Department as they may help you in obtaining the need documentation. SUBMITTED ONCE SUBMITTED EVERY YEAR Check the applicable letter in each box TUBERCULIN STATUS A. One-step TST: Skin Test Date Result: Neg Pos mm B. QuantiFERON (QFT) Date Result: OR C. If New Positive/Exam/X-ray Date: OR D. Positive TST/Negative X-ray Date: HEPATITIS B (3 primary series shots: (at 0,1,6, mo) plus titer confirmation (6-8 weeks later) A. Vaccination Dates 1) 2) 3) B. Immunity confirmed by titer Date MMR (Measles, Mumps, Rubella) A. Vaccination Dates 1) 2) OR B. Immunity by titers: Measles Date Mumps Date Rubella Date VARICELLA (Chicken Pox) A. Vaccination Dates 1) 2) OR B. Immunity by titer Date TETANUS,DIPTHERIA, PERTUSSIS (Tdap) A. Tdap Date B. Td Date C. Pertussis: Date: (if you obtained a Td) CPR AHA BCLS Healthcare Provider Certificate Expiration Date Check the applicable letter in each box INFLUENZA A. Proof of annual vaccination(s) Date 1 Date 2 OR

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