Patient Care Technician Program

Size: px
Start display at page:

Download "Patient Care Technician Program"

Transcription

1 Workforce and Continuing Education Division Patient Care Technician Program This program prepares a student to work as an entry-level patient care technician in a clinic, hospital, nursing home or long-term care facility. Students will learn to perform basic laboratory procedures and electrocardiograms, check vital signs, assist in medical examinations and how to perform, and gain experience in phlebotomy. This program is a combination of lecture and practical exercises in the medical laboratory. Upon successful completion of this program, the student is eligible to take the State of Texas Nurse's Aide Certification exam as well as the National Center for Competency Testing, NCCT, certification exams for EKG, Phlebotomy and Patient Care Technician Certification. Patient Care Technician Part One, Two or Three may be taken in any order however; course prerequisites must be completed prior to registration. The following are not included in the cost of the course and are the responsibility of the student: The State of Texas Nurse s Aide Certification exam; National Center for Competency Testing, NCCT Certification exams for EKG, Phlebotomy and Patient Care Technician; Criminal background check; Liability insurance, Uniform (royal blue); Watch with second hand and; Textbooks. IT ALL BEGINS HERE!

2 Patient Care Technician Program CHECK LIST All program prerequisites must be met before registering. Student Checklist Patient Care Technician, Part One (Phlebotomy Technician) High School Diploma or equivalent. Brookhaven College- Immunization Record must be completed and signed by Brookhaven College Health Center (Immunizations must be current; must have had three doses of Hepatitis B Vaccine; and TB test). Dallas County Community College District, Continuing/Workforce Education Registration Form. Patient Care Technician, Part Two (EKG Technician Certification) High School Diploma or equivalent. Dallas County Community College District, Continuing/Workforce Education Registration Form. Patient Care Technician, Part Three (Nurse Aid Certification) High School Diploma or equivalent. Brookhaven College- Immunization Record must be completed and signed by Brookhaven College Health Center (Immunizations must be current; must have had three doses of Hepatitis B Vaccine; and TB test). Nurse Aide Registry (NAR) Form Completed and signed. Ability to lift 50 lbs. Current Basic Cardiac Life Support, BCLS, for Health Care Providers card (within 2 years). Criminal Background check. Issued by instructor. Dallas County Community College District, Continuing/Workforce Education Registration Form.

3 Patient Care Technician Program Your registration packet includes the following: 1. Patient Care Technician Program Cover Sheet 2. Brookhaven College- Immunization Record Bring to the Brookhaven College Health Center Nurse for verification of immunizations. This form must be submitted to the Workforce and Continuing Education Division Office prior to registration. Please allow enough time to complete all three doses of the Hepatitis B Vaccine prior to registering for Patient Care Technician, Part One or Part Three. 3. Dallas County Community College District, Continuing/Workforce Education Registration Form A registration form has been provided for your convenience. For additional copies go to; Continuing Education Registration Form and to download additional copies. Please check with the Workforce and Continuing Education registration staff to make sure all course prerequisites have been met and all required forms have been submitted prior to registration. 4. Brookhaven College, Workforce and Continuing Education Nurse Aide Registry (NAR) Form- This form must be filled out prior to registering for Patient Care Technician, Part Three. 5. A student checklist Has been provided to help you keep track of the program requirements. Use this checklist to make sure you have met all prerequisites before registration. Helpful Information Please visit our health center for a list of shots they can assist you with. THE BHC HEALTH CLINIC CAN GIVE EITHER HEPATITIS SERIES. The most common series requires up to 6 months to complete however, the TWINRIX series can be completed within 21 days. TITER tests can be taken to confirm required immunizations. The Health Center is located in the Student Services Center, Building S, Room S072. Liability Insurance MUST be paid at the time of registration. Social Security Card Please note: You will be required to present your social security card at the time you take the State of Texas Nurse s Aide Certification Exam as well as the National Center for Competency Testing, NCCT, Certification exams for EKG, Phlebotomy and Patient Care Technician. These exams are not provided by Brookhaven College, Workforce and Continuing Education Division. For additional information about the nearest test site contact NCCT at,

4 BROOKHAVEN COLLEGE WORKFORCE AND CONTINUING EDUCATION NURSE AIDE REGISTRY (NAR) All applicants must be checked for listing on the Nurse Aide Registry, NAR, prior to admission. Pursuant to 42 code of Federal Regulation (CFR) (1)(ii), nurse aides with a finding of abuse, neglect, or misappropriation of resident s property are prohibited from employment in nursing and skilled nursing facilities. In addition 42 CFR (c)(4)(d) mandates that all findings of abuse, neglect, or misappropriation of resident s property remain on the registry permanently. In order to determine if an individual is listed on the Nurse Aide Registry as UNEMPLOYABLE due to abuse, neglect or misappropriation of resident s property, please call the departments toll-free voice information system at To Be Filled Out By Applicant: Full Name Social Security Number - - Have you ever been certified as a Nurse Aide in Texas? If yes, when? What name was on the certificate? I certify that the information provided in the above application is true and correct. I understand that false information on this application may result in immediate suspension or removal from the course with no refund. Signature of Applicant Date ************************************* To Be Filled Out By Sponsored Agency Representative or Training Program Representative if Applicant has no Sponsor. Nurse Aide Registry checked? Yes No Results: Signature of Representative / Date

5 Continuing/Workforce Education Registration Educational opportunities are offered by the Dallas County Community College District without regard to race, color, age, national origin, religion, sex, disability or sexual orientation. Please check the college you plan to attend. Brookhaven College Cedar Valley College Eastfield College El Centro College (ECC) 3939 Valley View Lane 3030 North Dallas Avenue 3737 Motley Drive Main & Lamar Streets Farmers Branch, TX Lancaster, TX Mesquite, TX Dallas, TX fax fax fax Mountain View College North Lake College Richland College ECC-Bill J. Priest Campus 4849 West Illinois Avenue 5001 N. MacArthur Blvd Abrams Road 1402 Corinth Street Dallas, TX Irving, TX Dallas, TX Dallas, TX fax fax fax fax Dallas TeleCollege 9596 Walnut Street Dallas, TX fax Student Information Please print. * Please check appropriate box; your responses to these questions are voluntary - information is used to meet Texas State reporting requirements only. New Student * Male *Social Security Number: - - Existing Student * Female DCCCD Student I.D. Number: Ethnicity information is used to meet Texas State reporting requirements and providing this information is voluntary on your part. White, Non-Hispanic Hispanic American Indian/Alaskan Native Other Black, Non-Hispanic Asian/Pacific Islander International/Non-Immigrant No Response Last Name First Name MI Address City State Zip County Country Home Phone Work Phone Cell Phone Fax Address Date of Birth I verify that the above information is accurate. Signature Date Course Information (Certain Continuing Education courses have entrance requirements that student must meet prior to registration. Consult college for details.) REG # TERM COURSE # SECTION # COURSE TITLE DAYS DATES TIME LOCATION FEE Payment Information You are able to pay by credit card on the web if you have previously registered and provided your address. If paying by check, include Driver s License Number and State on the top of the check, not on this form. Refund Policy: A refund of 100 percent will be made if requested prior to the first scheduled meeting day. Your request for a refund must be made during business hours prior to the first day of class to qualify for a 100 percent refund. A refund of 80 percent is allowed before the close of business on the day of the second class meeting. No refund is allowed after the second class meeting. Should the college cancel the class a 100 percent refund will be issued. Refunds may take up to four weeks to process. The Colleges of the Dallas County Community College District reserve the right to make changes that may include, but are not limited to, the days and times courses are offered, classroom location, instructors who teach the course, and cancellation of courses. Third Attempt to Enroll in a Course: Effective for Fall Semester 2005, the Dallas County Community Colleges will charge a higher tuition rate to students registering the third or subsequent time for a course. All third and subsequent attempts of the majority of credit and Continuing Education/Workforce Training courses will result in higher tuition to be charged. Developmental Studies and some other courses will not be charged a higher tuition rate. Third attempts include courses taken at any of the Dallas County Community Colleges since the Fall 2002 semester. FORM NO /06

6 Brookhaven College Immunization Record Workforce and Continuing Education Division Last Name First Name Middle Initial Date of Birth Sex: M F Student ID# *Please have the Brookhaven College Health Center Nurse initial form. MEASLES (Rubeola) HEPATITIS B Select option 1 or 2 and provide requested documentation. 1. Dates of immunization: Two (2) are required. A. First immunization with live attenuated virus. (Given after 1957 and given on or after student s first birthday.) B. Second immunization with live attenuated virus. (Given at least 30 days after first immunization.) Date of blood titer. (Must attach a copy of laboratory test in English.) 2. Date of immunization: / / ( )* / / ( )* OR Dates of immunization (Completion of three dose series required series MUST be completed prior to registration.) 1. Date of immunization: / / ( )* 2. Date of immunization: / / ( )* 3. Date of immunization : / / ( )* 1. Date of test: / / ( )* MUMPS Select option 1 or 2 and provide requested documentation. 1. Dates of immunization: Two (2) are required. a. First immunization with live attenuated virus. (Given after 1957 and given on or after student s first birthday.) 2. Date of blood titer. (Must attach a copy of laboratory test in English.) 1. Date of immunization: / / ( )*OR VARICELLA 1. History of disease: ( )* 2. Two (2) doses (4 weeks apart) / / ( )* / / ( )* 2. Date of test: / / ( )* RUBELLA (German Measles) Select option 1 or 2 and provide requested documentation. 1. First immunization with live attenuated virus. (Given after 1957 and given on or after student s first birthday.) 2. Date of blood titer. (Must attach a copy of laboratory test in English.) 1. Date of immunization: / / ( )* OR Td or Tdap/Tetanus, Diphtheria and Acellular Pertussis Date of most recent tetanus booster. (Within 10 years for All students.) 1. Date of immunization: / / ( )* 2. Date of test: / / ( )* MMR 1. Date of immunization: / / ( )* 2. Date of immunization: / / ( )* TB PPD Date: / / ( )* Result: Negative Positive mm. ( )* Chest X Ray: Negative Positive Brookhaven College Health Center Nurse Signature SIGNATURE: DATE:

Nurse Aide Certification Program and Patient Care Technician, Part Three Registration Packet

Nurse Aide Certification Program and Patient Care Technician, Part Three Registration Packet Nurse Aide Certification Program Brookhaven College Workforce Continuing Education Division COVER SHEET Prepare for the nurse aide certification examination with this course addressing both written clinical

More information

Nursing Assistant I Admission Requirements

Nursing Assistant I Admission Requirements Nursing Assistant I Admission Requirements 1. High School Diploma, GED or College Transcripts 2. Driver s License or State ID 3. Social Security Card 4. Physical Examination 5. Criminal Background Check

More information

Certified Nurse Aide (CNA) Training Program

Certified Nurse Aide (CNA) Training Program Continuing Education Application for permission to register in: Certified Nurse Aide (CNA) Training Program This application must be completed and submitted for approval before you can register for Certified

More information

EFFECTIVE CURRICULUMS

EFFECTIVE CURRICULUMS Courses Effective Curriculums Don t Just Happen CDEC 1008 Is your curriculum still effective? With so many changes in early childhood expectations, brain research and No Child Left Behind in effect, it

More information

Tuition: The cost for the program is $1438.25, which must be paid in full before course begins.

Tuition: The cost for the program is $1438.25, which must be paid in full before course begins. Ossining Extension Center Integrated Patient Care Technician Program Application Process 2014 The integrated patient care technician program (IPCT) is a 120-hour program designed to prepare Certified Nursing

More information

EL CENTRO COLLEGE CENTER FOR ALLIED HEALTH AND NURSING HEALTH OCCUPATIONS ADMISSIONS

EL CENTRO COLLEGE CENTER FOR ALLIED HEALTH AND NURSING HEALTH OCCUPATIONS ADMISSIONS EL CENTRO COLLEGE CENTER FOR ALLIED HEALTH AND NURSING HEALTH OCCUPATIONS ADMISSIONS PHYSICAL EXAMINATION AND IMMUNIZATION REQUIREMENTS In order to comply with the Texas Administrative Code (Title 25 Health

More information

Sterile Processing Technician Training

Sterile Processing Technician Training Sterile Processing Technician Training Information Sheet YOU MUST HAVE DEPARTMENT APPROVAL TO REGISTER IN THIS COURSE. REGISTRATION APPROVAL FORM MUST BE SIGNED BY APPROPRIATE PERSONNEL. The role of the

More information

Division of Continuing Education and Community Services Application for Nurse Assistant Course CNA APPLICATION CHECK LIST

Division of Continuing Education and Community Services Application for Nurse Assistant Course CNA APPLICATION CHECK LIST CNA APPLICATION CHECK LIST Applicant Name: Phone No: Alternative No: Application Date: Please submit this information to WCCC as soon as possible. You will not be eligible to start classes if we do not

More information

Continuing Education Healthcare Programs Admissions Packet Nurse Aide Training

Continuing Education Healthcare Programs Admissions Packet Nurse Aide Training Thank you for your interest in our continuing education healthcare courses. Enclosed you will find pre-admission information relevant to our Nurse Aide training. This application packet must be completed

More information

COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM

COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM 1 Health Sciences Division COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM APPLICATION PACKET Revised July 2014 2 University System of Georgia! An Affirmative Action/Equal Opportunity Institution DARTON STATE

More information

MEDICAL ASSISTANT PROGRAM Application and Information Packet HEALTH PROFESSIONS

MEDICAL ASSISTANT PROGRAM Application and Information Packet HEALTH PROFESSIONS Updated 01/07/2015 MEDICAL ASSISTANT PROGRAM Application and Information Packet HEALTH PROFESSIONS DEADLINE: August 7, 2015 (For fall semester) November 20, 2015 (For spring semester) 1 Allied Health Program

More information

ADMISSION TO THE MASSAGE THERAPY PROGRAM 2016

ADMISSION TO THE MASSAGE THERAPY PROGRAM 2016 Thank you for your interest in our Massage Therapy program. Caldwell Community College and Technical Institute is a co-educational college open to any individual meeting the admission requirements for

More information

Pharmacy Technician. Program Application Packet. Northeast Texas Community College is an equal opportunity, affirmative action, ADA institution.

Pharmacy Technician. Program Application Packet. Northeast Texas Community College is an equal opportunity, affirmative action, ADA institution. Pharmacy Technician Program Application Packet Pharmacy Tech Program APPLICATION Program description: This certificate program consists of 288 contact hours of lecture, lab and internship training for

More information

NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION

NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION Classes are offered at the following locations: Superstition Mountain Campus Signal Peak Campus Maricopa Campus Aravaipa Campus Spring Semesters

More information

MATC PRACTICAL NURSING (PN) PROGRAM

MATC PRACTICAL NURSING (PN) PROGRAM MATC PRACTICAL NURSING (PN) PROGRAM MOUNTAINLAND APPLIED TECHNOLOGY COLLEGE A Utah College of Applied Technology Campus SPRING 2016 P R AC TI C AL N U R S I NG AP P LI C ATI O N P AC KE T S P R I NG 2

More information

NOTE: Immunization requirements are based on CDC recommendations for health care workers and Clinical site requirements.

NOTE: Immunization requirements are based on CDC recommendations for health care workers and Clinical site requirements. 4500 Steilacoom Blvd SW Lakewood WA 98499 www.cptc.edu Practical Nurse Application WE DO NOT HAVE A DEADLINE FOR APPLICATIONS. WE ARE FIRST COME FIRST SERVED. THE WAITLIST IS CURRENTLY GREATER THAN THREE

More information

Surgical Technology Program Directions for Completing the Application 2013-2014

Surgical Technology Program Directions for Completing the Application 2013-2014 Surgical Technology Program Directions for Completing the Application 2013-2014 Thank you for applying to the Surgical Technician program at the Ossining Extension Center of Westchester Community College.

More information

Summa Center for EMS EMT Program Website: www.summa-ems.org Accreditation #324. Note that this course is limited to the first 20 applicants.

Summa Center for EMS EMT Program Website: www.summa-ems.org Accreditation #324. Note that this course is limited to the first 20 applicants. Enclosed is the application packet for the Fall 2015 EMT Course which begins on July 28 th and will be held on the Akron City Hospital Campus, Idabelle Firestone Center (School of Nursing). Note that this

More information

Pharmacy Technician Program. Pharmacy Technician. Program Application Packet. Health Professions Division

Pharmacy Technician Program. Pharmacy Technician. Program Application Packet. Health Professions Division Pharmacy Technician Program 12800 Abrams Road Dallas, Texas 75243-2199 972.238.6950 www.richlandcollege.edu/hp Health Professions Division Pharmacy Technician Program Application Packet Equal Opportunity

More information

Dear Nursing Student,

Dear Nursing Student, Dear Nursing Student, Again, congratulations on being accepted to the nursing program on the Tyler campus. The purpose of this packet is to share information regarding matters you need to take care of

More information

APPLICATION FOR THE RN to BSN PROGRAM NAME: ADDRESS:

APPLICATION FOR THE RN to BSN PROGRAM NAME: ADDRESS: APPLICATION FOR THE RN to BSN PROGRAM PLEASE PRINT CLEARLY NAME: ADDRESS: Please check Campus you wish to attend: Rutgers Camden: Atlantic Cape Community College: Camden County College at Blackwood: Home

More information

CNA CERTIFICATE PROGRAM APPLICATION PACKET

CNA CERTIFICATE PROGRAM APPLICATION PACKET CNA CERTIFICATE PROGRAM APPLICATION PACKET Application Instructions Thank you for your interest in the Certified Nursing Assistant Certificate Program at the College of Continuing and Professional Education

More information

School of Health Sciences. WSSU Division of Nursing. Accelerated Baccalaureate of Science in Nursing (ABSN) Option

School of Health Sciences. WSSU Division of Nursing. Accelerated Baccalaureate of Science in Nursing (ABSN) Option School of Health Sciences Division of Nursing Accelerated Baccalaureate of Science in Nursing (ABSN) Option Thank you for showing interest in the ABSN option at Winston-Salem State University (WSSU). Below

More information

University of Hawai i at Mānoa University Health Services Mānoa 1710 East-West Road, Honolulu, Hawai i 96822 (808) 956-8965 FAX: (808) 956-3583

University of Hawai i at Mānoa University Health Services Mānoa 1710 East-West Road, Honolulu, Hawai i 96822 (808) 956-8965 FAX: (808) 956-3583 University of Hawai i at Mānoa 1710 East-West Road, Honolulu, Hawai i 96822 (808) 956-8965 FAX: (808) 956-3583 Dear Entering Students: Welcome to University of Hawai i at Mānoa! The (UHSM) is located on

More information

PROGRAM TUITION DOWN PAYMENT. Patient Care Technician $3500 $2500. Pharmacy Technician $2500 $1500. Phlebotomy Technician $2300 $1300

PROGRAM TUITION DOWN PAYMENT. Patient Care Technician $3500 $2500. Pharmacy Technician $2500 $1500. Phlebotomy Technician $2300 $1300 APPLICATION INSTRUCTIONS AND CHECKLIST Please fill out the application completely. Then you can print and mail or bring it to Fast Track with your down payment. : PROGRAM TUITION DOWN PAYMENT Patient Care

More information

Phlebotomy Technician Training Program Checklist and Application. Student Name: Campus Requested:

Phlebotomy Technician Training Program Checklist and Application. Student Name: Campus Requested: Phlebotomy Technician Training Program Checklist and Application Student Name: Campus Requested: Thank you for your interest in our Phlebotomy Technician Training Program! All applicants must follow these

More information

Westchester Community College Ossining Extension Center 22 Rockledge Avenue Ossining, New York 10562 Attn: Surgical Technology Program

Westchester Community College Ossining Extension Center 22 Rockledge Avenue Ossining, New York 10562 Attn: Surgical Technology Program Central Sterile Processing Program Directions for Completing the Application Fall 2012 Ossining Extension Center, 22 Rockledge Avenue Ossining, New York 10562 Thank you for your interest in the Central

More information

SOUTHWESTERN COLLEGE OPERATING ROOM NURSING PROGRAM. MINIMUM QUALIFICATIONS - All applicants must hold a current California RN license.

SOUTHWESTERN COLLEGE OPERATING ROOM NURSING PROGRAM. MINIMUM QUALIFICATIONS - All applicants must hold a current California RN license. The Operating Room Nursing Program is designed to teach RN s to function in the operating room. A class of 10 students is accepted each fall. Qualified applicants are accepted in the order in which they

More information

Continuing Education Healthcare Programs Admissions Packet Nurse Aide Training

Continuing Education Healthcare Programs Admissions Packet Nurse Aide Training Thank you for your interest in our continuing education healthcare courses. Enclosed you will find pre-admission information relevant to our Nurse Aide training. This application packet must be completed

More information

School of Nursing Application Packet for Admission to the RN to BSN Option

School of Nursing Application Packet for Admission to the RN to BSN Option School of Nursing Application Packet for Admission to the RN to BSN Option Please follow the steps outlined below to complete your application. A. To the Bellin Health Chief Nursing Officer, Laura Hieb,

More information

All Nursing Students. Yearly Physical Exam, Current CPR Card, Personal Health Insurance, Malpractice Insurance (Graduate Students only)

All Nursing Students. Yearly Physical Exam, Current CPR Card, Personal Health Insurance, Malpractice Insurance (Graduate Students only) To: Subject: All Nursing Students Yearly Physical Exam, Current CPR Card, Personal Health Insurance, Malpractice Insurance (Graduate Students only) All nursing students must meet the following criteria

More information

School of Health and Human Services Nursing Program Application Package

School of Health and Human Services Nursing Program Application Package School of Health and Human Services Nursing Program Application Package To All Applicants of the BSN Program: The BSN Program is demanding and requires academic ability; physical, mental and emotional

More information

South Arkansas Health Care Opportunity South Arkansas Community College Health Sciences Program Application

South Arkansas Health Care Opportunity South Arkansas Community College Health Sciences Program Application South Arkansas Health Care Opportunity South Arkansas Community College Health Sciences Program Application Phlebotomy/EKG Admission to South Arkansas Community College and the above listed Health Science

More information

Quest Nursing Education Center 2135 Broadway, Oakland, CA 94612 P: (510) 452-1444 www.questnursingeducationcenter.com. Enrollment Application

Quest Nursing Education Center 2135 Broadway, Oakland, CA 94612 P: (510) 452-1444 www.questnursingeducationcenter.com. Enrollment Application STUDENT INFORMATION Enrollment Application Name: Address: Phone: Email: Last First MI Other Name Used Number / Street City State Zip Daytime Evening Message DOB: SSN: - - POB: mm/dd/yyyy Place of Birth

More information

Certified Nurse Aide Training Program Checklist and Application. Student Name: Campus Requested:

Certified Nurse Aide Training Program Checklist and Application. Student Name: Campus Requested: Certified Nurse Aide Training Program Checklist and Application Student Name: Campus Requested: Thank you for your interest in our Certified Nurse Aide Training Program! All applicants must follow these

More information

Health Information Technology Program Information and Application Packet 2015-2016

Health Information Technology Program Information and Application Packet 2015-2016 Health Information Technology Program Information and Application Packet 2015-2016 PROGRAM DESCRIPTION The Health Information Technology program will prepare the student to be a Health Information Technician.

More information

San Jacinto College North Campus Medical Assisting

San Jacinto College North Campus Medical Assisting San Jacinto College North Campus Medical Assisting Student ID # APPLICATION FOR ADMISSION Date You are urged to give careful consideration to each question on this form. It is to your advantage to complete

More information

COST. CONTACT NEMCC Office of Continuing Education (662) 720-7296

COST. CONTACT NEMCC Office of Continuing Education (662) 720-7296 Certified Nursing Assistant Training Program Class Information Fall 2014 (Keep for your records) CLASS SCHEDULE September 8, 2014 - November 15, 2014 Booneville - Monday & Tuesday nights (5:30-9:30) September

More information

Student Records office Columbia Basin College 2600 North 20th Avenue Pasco, WA 99301

Student Records office Columbia Basin College 2600 North 20th Avenue Pasco, WA 99301 Surgical Technology Annual Application First day to submit is June 20, last day to submit is July 23 each year. The attached materials provide an application submission guide for the Surgical Technology

More information

Student Application Forms 2015-2016. P a g e 1

Student Application Forms 2015-2016. P a g e 1 Department of PHARMACY TECHNICIAN Student Application Forms 2015-2016 P a g e 1 P a g e 2 Dear Prospective Student: Thank you for your interest in the Pharmacy Technician Program at San Jacinto College

More information

RN OPTION APPLICATION

RN OPTION APPLICATION 4500 Steilacoom Blvd SW Lakewood WA 98499 www.cptc.edu RN OPTION APPLICATION WE DO NOT HAVE A DEADLINE FOR APPLICATIONS. WE ARE FIRST COME FIRST SERVED. ONCE AN APPLICATION IS RECEIVED AND CONSIDERED COMPLETE,

More information

Continuing Education Allied Health Programs Certified Nurse Aide (CNA) - Student Requirements:

Continuing Education Allied Health Programs Certified Nurse Aide (CNA) - Student Requirements: Certified Nurse Aide (CNA) - Student Requirements: STAFF VERIFICATION: DATE: COMMENTS: Desired Class Date: _ Session: CEQ Name: Address: City:, Texas Zip: Phone #: Alt #: Email: Students entering the Certified

More information

PD:lt Patient Care. Education. Research. Community Service An Affirmative action/equal opportunity institution

PD:lt Patient Care. Education. Research. Community Service An Affirmative action/equal opportunity institution University Health Services University of Cincinnati PO Box 670460 Cincinnati OH 45267-0460 Holmes Building Phone (513) 584-4457 Fax (513) 584-2222 Date: April 15, 2015 TO: All Matriculating Pharmacy Students

More information

THE PRE-REGISTRATION PROCESS AND DEPARTMENTAL CLEARANCE IS REQUIRED EACH TIME THAT YOU ATTEMPT TO REGISTER FOR NURSING 095 (NURSING ASSISTANT CLASS)

THE PRE-REGISTRATION PROCESS AND DEPARTMENTAL CLEARANCE IS REQUIRED EACH TIME THAT YOU ATTEMPT TO REGISTER FOR NURSING 095 (NURSING ASSISTANT CLASS) Central Oregon Community College Nursing Department 2600 N.W. College Way; Bend, Oregon 97701 Instructions for Department Clearance to Register for NUR 095 Term: Winter 2014 THE PRE-REGISTRATION PROCESS

More information

DENTAL ASSISTANT PROGRAM PROGRAM REQUIREMENT PACKET

DENTAL ASSISTANT PROGRAM PROGRAM REQUIREMENT PACKET DENTAL ASSISTANT PROGRAM PROGRAM REQUIREMENT PACKET 4500 Steilacoom Blvd SW Lakewood, WA 98499 www.cptc.edu DENTAL ASSISTANT APPLICATION PLEASE REFER TO THESE PAGES FOR INFORMATION REGARDING THE ADMISSION

More information

Explanation of requirements for clinical experiences HFU

Explanation of requirements for clinical experiences HFU Page 1 Explanation of requirements for clinical experiences HFU Two Step TB screening Explanation of Required Immunizations and Health Requirements All nursing students are required to have an initial

More information

SURGICAL TECHNOLOGY PROGRAM APPLICATION

SURGICAL TECHNOLOGY PROGRAM APPLICATION SURGICAL TECHNOLOGY PROGRAM APPLICATION Dear Applicant: Thank you for your interest in Wharton County Junior College s Surgical Technology Program. Information on the program and the requirements necessary

More information

DENTAL ASSISTANT PROGRAM PROGRAM REQUIREMENT PACKET

DENTAL ASSISTANT PROGRAM PROGRAM REQUIREMENT PACKET DENTAL ASSISTANT PROGRAM PROGRAM REQUIREMENT PACKET 4500 Steilacoom Blvd SW Lakewood, WA 98499 www.cptc.edu DENTAL ASSISTANT APPLICATION PLEASE REFER TO THESE PAGES FOR INFORMATION REGARDING THE ADMISSION

More information

COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM

COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM 1 School of Health Professions COMPUTED TOMOGRAPHY CERTIFICATE PROGRAM APPLICATION PACKET University System of Georgia An Affirmative Action/Equal Opportunity Institution 2 Dear Applicant, Thank you for

More information

NURSING STUDENT HEALTH & IMMUNIZATION RECORDS

NURSING STUDENT HEALTH & IMMUNIZATION RECORDS NURSING STUDENT HEALTH & IMMUNIZATION RECORDS *********************************** COMPLETE THE ATTACHED HEALTH PACKET AND SUBMIT TO THE NURSING DEPARTMENT NO LATER THAN THE ASN ORIENTATION. **************************************

More information

El Centro College Continuing/Workforce Education CERTIFIED NURSE AIDE

El Centro College Continuing/Workforce Education CERTIFIED NURSE AIDE El Centro College Continuing/Workforce Education CERTIFIED NURSE AIDE GENERAL COURSE INFORMATION What do Nurse Aides do? Nurse aides work in nursing homes and other long-term care facilities to give basic,

More information

SKILL CENTER PROGRAMMING NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION

SKILL CENTER PROGRAMMING NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION SKILL CENTER PROGRAMMING NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION Classes are offered at the following location: Casa Grande Center 1015 E. Florence Blvd, A100 Casa Grande, AZ 85122

More information

Hunter College Online Application Instructions

Hunter College Online Application Instructions Hunter College Online Application Instructions You must apply no later than August 1, 2014. For support, please contact Graduate Admissions at 212-396-6049. Step 1: Start your application by visiting:

More information

Print Provider Packet and schedule an appointment with your healthcare provider to complete the packet.

Print Provider Packet and schedule an appointment with your healthcare provider to complete the packet. Due Dates: Incoming Fall Students July 15 th Incoming Spring Students December 15 th Incoming Summer Students July 15 th THESE FOLLOWING ARE REQUIRED BY NJ STATE LAW AND ROWAN UNIVERSITY POLICY. FAILURE

More information

School of Health and Human Services Health Care Assistant Program Application Package

School of Health and Human Services Health Care Assistant Program Application Package School of Health and Human Services Health Care Assistant Program Application Package We are pleased you are interested in the Health Care Assistant (HCA) Program. The HCA Program is recognized by the

More information

Eight Month Medical Assistant Training Program

Eight Month Medical Assistant Training Program Medical Assistant Medical Assistant Weatherford College In Partnership with Condensed Curriculum International (CCI) Program Summary: As a Medical Assistant the student will be trained to help the physician

More information

RN REFRESHER. Course Information

RN REFRESHER. Course Information RN REFRESHER Course Information What classes do I have to take? RNSG1006 RN Refresher Theory (100 hours) - Current nursing practice as related to the clinical areas of medical-surgical, maternal-child,

More information

SELECTION CRITERIA Completed packet (Refer to Page 2 Checklist) with FULL payment of fee to reserve class slot (First Come First Serve Basis)

SELECTION CRITERIA Completed packet (Refer to Page 2 Checklist) with FULL payment of fee to reserve class slot (First Come First Serve Basis) Certified Nursing Assistant Training Program Class Information Fall 2013 CLASS SCHEDULE TBA- Booneville - Monday & Thursday nights (5:00-9:00) TBA - Corinth - Monday & Thursday nights (5:00-9:00) TBA -

More information

Eight Month Medical Assistant Training Program

Eight Month Medical Assistant Training Program Medical Assistant Medical Assistant Weatherford College In Partnership with Condensed Curriculum International (CCI) Program Summary: As a Medical Assistant the student will be trained to help the physician

More information

2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR MEDICAL LABORATORY TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-MLAB)

2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR MEDICAL LABORATORY TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-MLAB) 2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR MEDICAL LABORATORY TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-MLAB) PROGRAM CONTACT INFORMATION Program Coordinator: Dr. Victoria

More information

The Immunization Office, located in the Student Health Center, is open year round to administer needed immunizations at a nominal fee.

The Immunization Office, located in the Student Health Center, is open year round to administer needed immunizations at a nominal fee. Student Health Services 2815 Cates Avenue Raleigh, NC 27695-7304 919-515-2563 healthcenter.ncsu.edu The Immunization Record Form is designed to collect information about your current immunization status.

More information

LEARN ON DEMAND LPN-ADN PROGRAM APPLICATION PACKET

LEARN ON DEMAND LPN-ADN PROGRAM APPLICATION PACKET LEARN ON DEMAND LPN-ADN PROGRAM APPLICATION PACKET Dear Student, Please complete this entire application packet in order to be considered for admission into the KCTCS Online LPN-ADN program. Please mail,

More information

San Jacinto College North Campus Medical Assisting

San Jacinto College North Campus Medical Assisting San Jacinto College North Campus Medical Assisting Student ID # APPLICATION FOR ADMISSION Date You are urged to give careful consideration to each question on this form. It is to your advantage to complete

More information

Program Counselor: Patsy Saenz Phone #: 915-831-4608 Office Location: RG Counseling Dept., 103 Montana Ave., 3 rd. floor

Program Counselor: Patsy Saenz Phone #: 915-831-4608 Office Location: RG Counseling Dept., 103 Montana Ave., 3 rd. floor PROGRAM CONTACT INFORMATION 2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR PHARMACY TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-PHRA) CERTIFICATE OF COMPLETION (C2-PHRC) Program

More information

CERTIFIED NURSE AIDE

CERTIFIED NURSE AIDE CERTIFIED NURSE AIDE Course Information What do nurse aides do? Nurse aides work in nursing homes and other long-term care facilities to give basic, daily care to residents. What classes do I have to take?

More information

Updated 04/29/2015. Medical Laboratory Technology Application and Information Packet HEALTH PROFESSIONS

Updated 04/29/2015. Medical Laboratory Technology Application and Information Packet HEALTH PROFESSIONS Updated 04/29/2015 Medical Laboratory Technology Application and Information Packet HEALTH PROFESSIONS DEADLINE: August 7, 2015 1 Health Professions at Utah State University-Eastern Blanding Campus Medical

More information

NON-TRADITIONAL VOLUNTEER APPLICATION PACKET

NON-TRADITIONAL VOLUNTEER APPLICATION PACKET CATEGORIES Non-Traditional Volunteers: Internships Practicums Research Observation of clinical activities Students NON-TRADITIONAL VOLUNTEER APPLICATION PACKET Human Resources Department 3601 A Street

More information

All courses are for College Credit!

All courses are for College Credit! All courses are for College Credit! bhcchilddevelopment@dcccd.edu 972-860-4700 www.brookhavencollege.edu Child Development Program 3939 Valley View Lane Farmers Branch, TX 75244-4997 2010 NONPROFIT ORG

More information

MEDICAL ASSISTING CERTIFICATE PROGRAM APPLICATION PACKET

MEDICAL ASSISTING CERTIFICATE PROGRAM APPLICATION PACKET MEDICAL ASSISTING CERTIFICATE PROGRAM APPLICATION PACKET Application Instructions Thank you for your interest in the Medical Assisting Certificate Program at the College of Continuing and Professional

More information

School of Health and Human Services Pharmacy Technician Program Application Package

School of Health and Human Services Pharmacy Technician Program Application Package School of Health and Human Services Pharmacy Technician Program Application Package We are pleased you are interested in the Pharmacy Technician Program. Our program is fully accredited with the Canadian

More information

Ghazvini Center for Healthcare Education 1528 Surgeons Drive Tallahassee, Florida 32308-4631 850.558.4500 phone

Ghazvini Center for Healthcare Education 1528 Surgeons Drive Tallahassee, Florida 32308-4631 850.558.4500 phone Ghazvini Center for Healthcare Education 1528 Surgeons Drive Tallahassee, Florida 32308-4631 850.558.4500 phone Nurse Assistant Program (HCP0122) Program Code 5024 120 hours of instruction Cost approximately

More information

Undergraduate Application for Admission Certificate Programs

Undergraduate Application for Admission Certificate Programs Undergraduate Application for Admission Certificate Programs GENERAL APPLICATION REQUIREMENTS All students applying to undergraduate degree and certificate programs at Marylhurst University must submit:

More information

Medical Assistant Training Program Checklist and Application. Student Name: Campus Requested:

Medical Assistant Training Program Checklist and Application. Student Name: Campus Requested: Medical Assistant Training Program Checklist and Application Student Name: Campus Requested: Thank you for your interest in our Medical Assistant Training Program! Please check the last page of this application

More information

HEALTH OCCUPATIONS PSYCHIATRIC TECHNICIAN PROGRAM APPLICATION PACKET

HEALTH OCCUPATIONS PSYCHIATRIC TECHNICIAN PROGRAM APPLICATION PACKET HEALTH OCCUPATIONS PSYCHIATRIC TECHNICIAN PROGRAM APPLICATION PACKET Applications will only be accepted during the posted application period for the semester you are applying for. Acceptance letters will

More information

Program Coordinator: Andrea Ceron Phone #: 915-831-4139

Program Coordinator: Andrea Ceron Phone #: 915-831-4139 PROGRAM CONTACT INFORMATION 2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR MEDICAL ASSISTING ASSOCIATE OF APPLIED SCIENCE (AAS-MDCA) AND CERTIFICATE OF COMPLETION (C2-MDCC) Program

More information

UACTI EMT Program Application Information:

UACTI EMT Program Application Information: UACTI EMT Program Application Information: Tuition for the EMT program is $925 plus a $25.00 nonrefundable application fee. Tuition includes a uniform shirt and textbook. Tuition also includes the student

More information

COLUMBUS STATE COMMUNITY COLLEGE Nursing, Respiratory, Imaging, Surgical Technology, Sterile Processing, or Medical Assisting Program

COLUMBUS STATE COMMUNITY COLLEGE Nursing, Respiratory, Imaging, Surgical Technology, Sterile Processing, or Medical Assisting Program 1 Nursing, Respiratory, Imaging, Surgical Technology, Sterile Processing, or Medical Assisting Program HEALTH HISTY To be completed by the Student: PLEASE PRINT ALL INFMATION COUGAR I.D. Name: SS#: Last

More information

Application Packet. Patient Care Technician Program. School of Math/Science/Health Professions Sabine Hall SH205

Application Packet. Patient Care Technician Program. School of Math/Science/Health Professions Sabine Hall SH205 Patient Care Technician Program + 12800 Abrams Road Dallas, Texas 75243-2199 972.238.6950 or 972.238-6920 richlandcollege.edu/hp School of Math/Science/Health Professions Sabine Hall SH205 Patient Care

More information

IMPERIAL VALLEY CAMPUS. RN-BS in Nursing Program APPLICATION FOR ADMISSION

IMPERIAL VALLEY CAMPUS. RN-BS in Nursing Program APPLICATION FOR ADMISSION SAN DIEGO STATE UNIVERSITY COLLEGE OF HEALTH AND HUMAN SERVICES SCHOOL OF NURSING IMPERIAL VALLEY CAMPUS RN-BS in Nursing Program APPLICATION FOR ADMISSION I. General Information The Imperial Valley Campus

More information

Overview. Certification

Overview. Certification Collin College Division of Health Sciences and Emergency Services Certificate in Central Sterile Processing Central Sterile Processing Admission Packet Overview Thank you for your interest in the Certificate

More information

Nurse Aide. Clinicals ** April 25 April 27, 2016 7:00 A.M. 3:00 P.M. or 6:00 A.M.-2:00 P.M.

Nurse Aide. Clinicals ** April 25 April 27, 2016 7:00 A.M. 3:00 P.M. or 6:00 A.M.-2:00 P.M. Nurse Aide January 11, 2016 February 11, 2016 5:00-9:00 P.M., Monday-Thursday Clinicals ** February 15 17, 2016 7:00 A.M. 3:00 P.M. or 6:00 A.M.-2:00 P.M. March 21, 2016 April 21, 2016 5:00-9:00 P.M.,

More information

NURSE AIDE EXAM REVIEW

NURSE AIDE EXAM REVIEW NURSE AIDE EXAM REVIEW Course Information PURPOSE This course provides an opportunity to refresh current skills and receive instruction in recently developed techniques needed for effective patient care.

More information

How To Get A Degree In Radiologic Technology

How To Get A Degree In Radiologic Technology CENTRAL ARIZONA COLLEGE RADIOLOGIC TECHNOLOGY PROGRAM ASSOCIATE IN APPLIED SCIENCE DEGREE INFORMATION AND ADMISSIONS PACKET Superstition Mountain Campus Radiologic Technology Radiologic Technology is a

More information

Certified Clinical Medical Assistant

Certified Clinical Medical Assistant Application for Certified Clinical Medical Assistant Cumberland Salem Workforce Education Alliance Certified Clinical Medical Assistant Program The Clinical Medical Assistant works in a physician s office

More information

BACHELOR OF SCIENCE IN ORGANIZATIONAL LEADERSHIP

BACHELOR OF SCIENCE IN ORGANIZATIONAL LEADERSHIP BACHELOR OF SCIENCE IN ORGANIZATIONAL LEADERSHIP APPLICATION 1938 Emporium Drive Jackson, TN 38305 731.661.5163 2745 Hacks Cross Road Germantown, TN 38138 901.312.1943 205 Indian Lake Boulevard Hendersonville,

More information

INSTRUCTIONS & REQUIREMENTS FOR CLINICAL PRACTICA

INSTRUCTIONS & REQUIREMENTS FOR CLINICAL PRACTICA 2014 UMass Amherst College of Nursing INSTRUCTIONS & REQUIREMENTS FOR CLINICAL PRACTICA The requirements and guidelines for finding a clinical practice site June 24, 2014 Dear Students, This is a reminder

More information

Emergency Medical Technician Course Application

Emergency Medical Technician Course Application Community Health Network Emergency Medical Technician Course Application July 2016 First day of Class July 11, 2016 EMERGENCY MEDICAL SERVICES & EDUCATION Thank you for your consideration in choosing Community

More information

MEDICAL INTERPRETATION

MEDICAL INTERPRETATION MEDICAL INTERPRETATION Course Information What do Medical Interpreters do? Medical Interpreters perform a variety of interpretation services to assist non- English speaking patients receiving care within

More information

Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL 32837

Millers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL 32837 Congratulations on your decision to pursue your degree in nursing. The Millers College of Nursing offers a career pathway to the Bachelor of Science in Nursing. The pathway provides learning activities

More information

Bachelor of Science in Nursing (BSN) Program Application

Bachelor of Science in Nursing (BSN) Program Application Bachelor of Science in Nursing (BSN) Program Application Location: Licensure: Accreditation: Columbia College The Columbia College BSN Nursing Program is offered at the main campus in Columbia, Missouri

More information

Program Coordinator: Lourdes Garduno Phone #: 915-831-4048 Office Location: RG Campus, Health Science Bldg. RM H-231

Program Coordinator: Lourdes Garduno Phone #: 915-831-4048 Office Location: RG Campus, Health Science Bldg. RM H-231 PROGRAM CONTACT INFORMATION 2016-2017 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR DENTAL ASSISTING ASSOCIATE OF APPLIED SCIENCE (AAS-DNTA) AND CERTIFICATE OF COMPLETION (C2-DNTC) Program

More information

INSTRUCTIONS FOR APPLYING FOR THE SCHOOL DISTRICT BUSINESS LEADER, POST MASTER S DEGREE, ADVANCED GRADUATE CERTIFICATE PROGRAM

INSTRUCTIONS FOR APPLYING FOR THE SCHOOL DISTRICT BUSINESS LEADER, POST MASTER S DEGREE, ADVANCED GRADUATE CERTIFICATE PROGRAM INSTRUCTIONS FOR APPLYING FOR THE SCHOOL DISTRICT BUSINESS LEADER, POST MASTER S DEGREE, ADVANCED GRADUATE CERTIFICATE PROGRAM BEFORE SUBMITTING YOUR APPLICATION, MAKE SURE YOU COMPLY WITH ALL OF THE INSTRUCTIONS

More information

2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR SURGICAL TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-SRGT)

2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR SURGICAL TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-SRGT) PROGRAM CONTACT INFORMATION 2015-2016 Catalog SPECIALIZED ADMISSIONS PROGRAM INFORMATION GUIDE FOR SURGICAL TECHNOLOGY ASSOCIATE OF APPLIED SCIENCE (AAS-SRGT) Program Coordinator: Cynthia Rivera Phone

More information

Trinity Washington University School of Nursing and Health Professions Nursing Program Application Packet Checklist Spring Semester, 2013

Trinity Washington University School of Nursing and Health Professions Nursing Program Application Packet Checklist Spring Semester, 2013 Trinity Washington University School of Nursing and Health Professions Nursing Program Application Packet Checklist Spring Semester, 2013 Please make an appointment to meet with your academic advisor to

More information

SURGICAL TECHNOLOGY PROGRAM APPLICATION

SURGICAL TECHNOLOGY PROGRAM APPLICATION SURGICAL TECHNOLOGY PROGRAM APPLICATION Dear Applicant: Thank you for your interest in Wharton County Junior College s Surgical Technology Program. Information on the program and the requirements necessary

More information

VILLANOVA UNIVERSITY COLLEGE OF NURSING GRADUATE PROGRAM DIRECTIONS TO COMPLETING PRACTICUM APPLICATION

VILLANOVA UNIVERSITY COLLEGE OF NURSING GRADUATE PROGRAM DIRECTIONS TO COMPLETING PRACTICUM APPLICATION VILLANOVA UNIVERSITY GRADUATE PROGRAM DIRECTIONS TO COMPLETING PRACTICUM APPLICATION DUE DATE Dates for submission of Practicum applications vary depending on the semester in which you plan to enroll in

More information

STUDENT CERTIFIED NURSING ASSISTANT APPLICATION DETAILED INSTRUCTIONS

STUDENT CERTIFIED NURSING ASSISTANT APPLICATION DETAILED INSTRUCTIONS STUDENT CERTIFIED NURSING ASSISTANT APPLICATION DETAILED INSTRUCTIONS PHYSICAL EXAMINATION REPORT INSTRUCTIONS: The Physical Examination Report located at the end of this document must be completed by

More information

INTERNATIONAL STUDENT SERVICES PLYMOUTH, QUINCY & ONLINE

INTERNATIONAL STUDENT SERVICES PLYMOUTH, QUINCY & ONLINE INTERNATIONAL STUDENT SERVICES PLYMOUTH, QUINCY & ONLINE Quincy College International Student Services 1250 Hancock Street Quincy Center, MA 02169, USA www.quincycollege.edu international@quincycollege.edu

More information

Baccalaureate Degree Program. Application for Admission & Readmission RN-BSN Track

Baccalaureate Degree Program. Application for Admission & Readmission RN-BSN Track Baccalaureate Degree Program Application for Admission & Readmission RN-BSN Track Please read the application carefully and fill it in completely. Incomplete applications will not be accepted. Admission

More information

High School Concurrent Enrollment

High School Concurrent Enrollment High School Concurrent Enrollment Office of Admissions 900 N. Portland Ave Oklahoma City, OK 73107 405.945.3224 405.945.9120 (Fax) admissions@osuokc.edu www.osuokc.edu Name: SSN#: Expected Graduation :

More information