DENTAL HYGIENE PROGRAM

DENTAL HYGIENE PROGRAM Central Georgia Technical College Warner Robins Campus 80 Cohen Walker Drive Warner Robins, GA 31088 (478)988-6850 Macon Campus 3300 Macon Tech Drive Macon, GA 31206 (478)757-3403 www.centralgatech.edu Revised July 2015

Dental Hygiene Program Selection Admission to the College and selection into the Dental Hygiene Program are two distinct processes. Students are responsible for understanding both processes. Questions regarding admission to the college should be directed to the Office of Admissions. Warner Robins Campus: (478) 988-6850 Macon Campus: (478) 757-3403 Questions regarding Dental Hygiene program selection should be directed to: Warner Robins Campus: Dr. Barbara Jansen, Program Chairperson, (478) 218-3244; bjansen@centralgatech.edu Macon Campus: April Catlett, Program Chairperson, 478) 757-3487; acatlett@centralgatech.edu As set forth in its Student Catalog, Central Georgia Technical College does not discriminate on the basis of race, color, creed, national or ethnic origin, gender, religion, disability, age, political affiliation or belief, disabled veteran, veteran of the Vietnam Era, or citizenship status (except in those special circumstances permitted or mandated by law). The following person has been designated to handle inquiries regarding the administration of the College nondiscrimination policies: Linda Hampton Executive Director of Conduct, Appeals and Compliance 3300 Macon Tech Drive Macon, GA 31206 Building J, Room 133 478-757-3408 FAX: 478-471-5197 CGTC ADMISSION REQUIREMENTS 1

FOR THE DENTAL HYGIENE PROGRAM Applicants must be at least 18 years old and have a high school diploma or its equivalent to be admitted to the Dental Hygiene program. Submit an application for college admission, along with a $20 non-refundable application fee. Schedule to take the COMPASS placement exam (offered in the Testing Center) in order to be admitted to the college. There is no charge for initial administration of the COMPASS exam. (Other placement exam scores may be acceptable, for example, SAT or ACT.) Request transfer credit for courses completed at accredited college(s) or other educational institutes, if applicable. Complete a Request for Transfer Credit prior to admission, and submit official transcripts to the Registrar s Office. DENTAL HYGIENE ADMISSION FILE CHECKLIST An applicant s official student record (housed in the Admissions Office) must contain the following items in order to be accepted for admission: Application for admission High School/GED or College Transcript Proof of age Placement Exam Scores (ASSET, COMPASS, SAT, ACT) PSB Health Aptitude Examination, 3 rd Edition * *The PSB exam is not required for admission to CGTC; however, it is required prior to selection into the Dental Hygiene Program and only 3 rd Edition scores will be considered in the selection process. No minimum score is required to be selected into the program. Students may take the exam at any time while taking their required core courses, but not later than mid-term in the semester prior to the semester for which you wish to be considered for selection. More information about the PSB exam may be obtained in the college Testing Centers or Media Centers or on-line at http://www.psbtests.com/web/guest CGTC DENTAL HYGIENE PROGRAM 2

SELECTION PROCEDURE Students are admitted to CGTC s Dental Hygiene Program through a process of competitive admission that includes four steps. Only those students who meet the minimum academic eligibility requirements (outlined below) will be considered for selection. 1) Successfully complete the required core courses ENGL 1101 (Composition and Rhetoric) minimum grade of C required ENG 191 will be accepted in lieu of ENGL 1101. MATH 1111 (College Algebra) or MATH 1101 (Math Modeling) minimum grade of C required with successful completion within the last five (5) years MAT 191 will be accepted in lieu of MATH 1111. CHEM 1211 (Chemistry I) and CHEM 1211L (Chemistry I Lab) minimum grade of C required with successful completion within the last five (5) years. BIOL 2113 (Anatomy and Physiology I) and BIOL 2113L (Anatomy and Physiology I Lab) minimum grades of C required with successful completion within the last five (5) years. BIOL 2114 (Anatomy and Physiology II) and BIOL 2114L (Anatomy and Physiology II Lab) minimum grades of C required with successful completion within the last five (5) years. BIOL 2117 (Introductory Microbiology) and BIOL 2117L (Introductory Microbiology Lab) minimum grades of C required with successful completion within the last five (5) years. DHYG 1130 will be accepted in lieu of BIOL 2117 and BIOL 2117L. Transfer Credit: Core courses requested for transfer credit from another institution must meet the above criteria in order to be accepted by CGTC. 2) Complete the PSB Aptitude Examination, 3 rd Edition.* Students may take the exam at any time while taking their required core courses, but not later than mid-term in the semester prior to the semester for which you wish to be considered for selection (March for the North Campus; June for the South Campus). Students may take the test two times in a year. The exam is administered in the CGTC Testing Center. There is a $20 testing fee. PSB scores are valid for only one year from date of test. Students will be eligible to retest in one year. *Only 3 rd Edition PSB scores will be considered in the selection process. 3) Submit documentation of previous dental office experience to the Admissions Office. Experience may be documented in one of two ways: Experience as a paid dental assistant (1 year or longer) verified by dentist/office manager on letterhead stationery. or Documented shadowing experience (40+ hours preferred) see Dental Hygiene Applicant Shadowing Form included in this packet. More than one shadowing form may be submitted if candidate shadows in more than one office. 4) Submit Progression/Application Form to the Registrar s Office. a. Students will not be considered for selection unless his/her name is on the list. All requirements for selection must be completed and official documents submitted (as listed on the Dental 3

Hygiene Admission File Checklist) by April 12 th in order to be considered for Summer semester (Macon Campus) and by midterm of Summer semester to be considered for the Fall semester (Warner Robins Campus). Students who are completing course requirements in the semester prior to selection may be accepted tentatively (based on mid-term grade provided by course instructor, and the course(s) must be taken at CGTC) until successfully completing the courses. b. If the student is not selected for the program but wishes to be considered for the following semester, the student must ensure that his/her application remains active by resubmitting a progression form/application. c. To submit the Progression Form go to the CGTC home page at www.centralgatech.edu Current Students Student Affairs Registrar Progression Form Request BannerWeb Log-in. Fill in the form and submit it electronically. Print a copy of the form for your records. Selection Criteria Upon successful completion of the required core courses and having taken the PSB exam, students will be considered for selection into the DHYG program based on the following criteria: 1. GPA will be calculated according to the following guidelines: a. Only courses taken within the required timeframe will be calculated in the GPA. b. Scoring: GPA x 100 plus highest PSB score. (90% of admission score) c. In the case of multiple attempts at a course(s) to achieve the required course grade or improve a grade, only the two most recent attempts will be calculated in the GPA. In the event that a student previously attempted coursework at institutions other than CGTC, official transcripts will be evaluated to include the two most recent attempts, and grades from any applicable coursework will be calculated in the GPA accordingly. 2. Dental Experience 10% of DHYG admission score Dental experience is scored based on the type and amount of previous dental experience. Points are awarded according to the following guidelines: Dental Assisting Experience (paid at least one year or more): 10 points Dental Assisting Experience (paid less than a year) or 40 or more hours of Dental Hygiene Shadowing: 7 points Dental Hygiene Shadowing (20-39 hours): 5 points Dental Hygiene Shadowing (1-19 hours): 3 points No Dental Hygiene Shadowing: 0 points Students will be ranked highest to lowest DHYG admission score. Available program slots are filled from the highest point score, decreasing until the class is filled. Tiebreaker: In the event of a tie in the ranking, the student s current PSB score will be used as the tiebreaker. In the event that a student has taken the PSB exam more than once, the current PSB scores will be averaged and the average of the two scores will be used in the tiebreaker process. Students will receive notification from the Admissions Office by phone or e-mail regarding selection results. At that time, instructions will be given as to registration for the upcoming semester and DHYG Program orientation. Post-selection Requirements 4

Once admitted to the Dental Hygiene program, students must have the following documents on file with the Dental Hygiene Program Chairperson prior to entering any DHYG course: Physical examination within the past year (form sent with acceptance letter). Copies of all immunization records (or proof of titers) to include tetanus vaccination, MMR vaccination, DPT vaccination, Hepatitis B vaccinations, and Varicella vaccination (a copy obtained from the Health Department is acceptable). Documentation of PPD (Tuberculin skin test) within the last 6 months. Proof of current CPR certification. CPR certification MUST be through the American Heart Association. * A criminal background check may be required prior to certain clinical rotations. Arrest or conviction of a misdemeanor (excluding minor traffic violations) or arrest or conviction of a felony could make a student ineligible to take the licensing exam(s) required by the profession. Early notification to the appropriate board is required. In the state of Georgia, the decision to license a graduate of a DHYG program rests solely with the Georgia Board of Dentistry. CGTC is not a licensure board and does not guarantee licensure to its DHYG program graduates. Readmission to the Dental Hygiene Program Students who voluntarily withdraw or are withdrawn from any Dental Hygiene course will not be allowed to continue in the program. In most instances (excluding withdrawal for certain disciplinary reasons), students will have the option of reapplying to the program the following year. Reentry to the program will be granted on a competitive and space-available basis. All admission criteria outlined above will be applicable. Additionally, re-entry students must demonstrate competency in all previously attained coursework. There will be no reentry credit for courses that are over two years old. In certain situations, students may retake a DHYG course at the other CGTC campus, providing that the student has taken the appropriate pre-requisite courses and space is available in the course at the other campus. DENTAL HYGIENE PROGRAM CURRICULUM Required Core Courses for Competitive Admission Course # Pre / Co Requisite Course Requirements (in suggested sequence) REQUIRED CORE COURSES 5 SEM Seq Credit Hours ENGL 1101 ENGL 0098, READ 0098 Composition & Rhetoric I Core 3 45 MATH 1111 or 1101 MATH 0099 College Algebra or Mathematical Modeling Core 3 45 BIOL 2117/ BIOL 2117L BIOL 2113/BIOL 2113L Introduction to Microbiology/ Microbiology LAB Core 3/1 90 CHEM 1211/ CHEM 1211L BIOL 2113/ BIOL 2113L BIOL 2114/ BIOL 2114 L Contact Hours MAT 1111 or 1101 Chemistry I/ Chemistry I LAB Core 3/1 90 ENGL 0098, READ 0098 BIOL 2113/BIOL 2113L Anatomy & Physiology I/ Anatomy & Physiology I LAB Core 3/1 90 Anatomy & Physiology II/ Anatomy & Physiology II LAB Core 3/1 90 Total Hours Core 22 450 DENTAL HYGIENE PROGRAM CURRICULUM SEQUENCE WARNER ROBINS CAMPUS Course # Pre / Co Requisite FALL 1 ST YEAR Only one: HUMN1101/MUSC 1101/ARTS1101/ENGL 2130 ENGL 1101 Humanities / Music Appreciation / Art Appreciation/American Literature SEM Seq Credit Hours Contact Hours Core 3 45

DHYG 1000 Program Admission Tooth Anatomy and Root Morphology 1 2 30 DHYG 1010 Program Admission Oral Embryology and Histology 1 1 15 DHYG 1020 Program Admission Head and Neck Anatomy 1 2 30 DHYG 1040 DHYG 1050 Preclinical Dental Hygiene Lecture 1 2 30 DHYG 1050 DHYG 1040 Preclinical Dental Hygiene Laboratory 1 2 90 Total Hours 1 st Semester 12 255 SPRING 1 st YEAR DHYG 1205 Program Admission Pharmacology and Pain Control 2 3 45 DHYG 1070 DHYG 1020/DHYG 1090 Radiology Lecture 2 2 30 DHYG 1090 DHYG 1020/DHYG 1070 Radiology Laboratory 2 1 30 DHYG 2050 DHYG 1010/DHYG 1020 General and Oral Pathology 2 3 45 DHYG 1110 DHYG 1040/DHYG 1111 Clinical Dental Hygiene I Lecture 2 2 30 DHYG 1111 DHYG 1050/DHYG 1110 Clinical Dental Hygiene I Laboratory 2 3 135 Total Hours 2 nd Semester 14 315 SUMMER 1 st YEAR (9 weeks) SPCH 1101 ENGL 0098, READ 0098 Public Speaking Core 3 45 DHYG 2010 DHYG 1110/DHYG 1070 Clinical Dental Hygiene II Lecture 3 2 30 DHYG 2020 DHYG 1070/DHYG 1090/DHYG 1111 Clinical Dental Hygiene II Laboratory 3 2 90 DHYG 1030 Program Admission Dental Materials 3 2 45 DHYG 2200 DHYG 1010 Periodontology 3 3 45 Total Hours 3 rd Semester 12 255 FALL 2 nd YEAR DHYG 2080 DHYG 2010/DHYG 2090 Clinical Dental Hygiene III Lecture 4 2 30 DHYG 2090 DHYG 2020/DHYG 2080 Clinical Dental Hygiene III Laboratory 4 4 180 DHYG 2070 DHYG 1110 Community Dental Health 4 3 75 DHYG 2110 Program Admission Biochemistry and Nutrition Fundamentals 4 2 30 Total Hours-4 th Semester 11 315 SPRING 2 nd YEAR PSYC 1101 ENGL 0098, READ 0098 Introduction to Psychology Core 3 45 SOCI 1101 ENGL 0098, READ 0098 Introduction to Sociology Core 3 45 DHYG 2130 DHYG 2080/DHYG 2140 Clinical Dental Hygiene IV Lecture 5 2 30 DHYG 2140 DHYG 2090/DHYG 2130 Clinical Dental Hygiene IV Laboratory 5 4 180 Total Hours-5 th Semester 12 300 Total Hours 83 1890 DENTAL HYGIENE PROGRAM CURRICULUM SEQUENCE MACON CAMPUS Course # Pre / Co Requisite SUMMER 1 st YEAR (10 Weeks) SEM Seq Credit Hours DHYG 1000 Program Admission Tooth Anatomy and Root Morphology 1 2 45 DHYG 1010 Program Admission Oral Embryology and Histology 1 1 15 SPCH 1101 ENGL 0098, READ 0098 Public Speaking Core 3 45 Contact Hours 6

PSYC 1101 ENGL 0098, READ 0098 Introduction to Psychology Core 3 45 Total Hours-1 st Semester 9 150 FALL 1 st YEAR DHYG 1020 Program Admission Head and Neck Anatomy 2 2 30 DHYG 1040 DHYG 1050 Preclinical Dental Hygiene Lecture 2 2 30 DHYG 1050 DHYG 1040 Preclinical Dental Hygiene Laboratory 2 2 90 DHYG 1070 DHYG 1020/DHYG 1090 Radiology Lecture 2 2 30 DHYG 1090 DHYG 1020/DHYG 1070 Radiology Laboratory 2 1 30 Total Hours-2 nd Semester 9 210 SPRING 1 st YEAR DHYG 1110 DHYG 1040/DHY 1111 Clinical Dental Hygiene I Lecture 3 1 15 DHYG 1111 DHYG 1050/DHY1110 Clinical Dental Hygiene I Laboratory 3 3 135 DHYG 1206 Program Admission Pharmacology 3 3 45 DHYG 2050 DHYG 1010/DHYG 1020 Oral Pathology 3 3 45 Total Hours-3 rd Semester 10 240 SUMMER 2 nd Year (10 Weeks) DHYG 1030 Program Admission Dental Materials 4 2 45 DHYG 2010 DHYG 1110/DHYG 1070 Clinical Dental Hygiene II Lecture 4 2 30 DHYG 2020 DHYG 1111/DHYG 1070 Clinical Dental Hygiene II Laboratory 4 2 90 DHYG 2200 DHYG 1010 4 3 45 Total Hours-4 th Semester 9 210 FALL 2 nd Year DHYG 2080 DHYG 2010/DHYG 2090 Dental Hygiene III Lecture 5 2 30 DHYG 2090 DHYG 2020/DHYG 2080 Clinical Dental Hygiene III Laboratory 5 4 180 DHYG 2110 Program Admission Biochemistry and Nutrition Fundamentals 5 3 45 SOCI 1101 ENGL 0098, READ 0098 Introduction to Sociology Core 3 45 Total Hours-5 th Semester 12 300 SPRING 2 nd Year DHYG 2070 DHYG 1110 Community Dental Health 6 3 75 DHYG 2130 DHYG 2080/DHYG 2140 Clinical Dental Hygiene IV Lecture 6 1 15 DHYG 2140 DHYG 2090/DHYG 2130 Clinical Dental Hygiene IV Laboratory 6 4 180 HUMN 1101/ARTS 1101/MUSC 1101/ENGL 2130 ENGL 1101 Humanities Elective Core 3 45 Total Hours-6 th Semester 11 315 Total Hours 83 1890 APPROXIMATE COST EXPECTATIONS (AFTER DENTAL HYGIENE [DHYG] SELECTION) All prices listed below are estimates and subject to change FIRST-YEAR STUDENTS Prior to beginning program: Physical Examination $ ~60.00 Immunizations ~255.00 (Health Dept. HepB - $70; Tetanus - $16; Varicella - $102; TB - $67) 7

CPR Training 55.00 Total $ 370.00 Fall Semester (includes Summer Semester if at North Campus): Books* $ 343.00 SADHA dues 0.00 (Currently paid by Student Leadership Council) Instruments 820.00-940.00(Includes ALL instruments required for program; financing 2 Scrub uniforms ($40 per set) 80.00 available) Lab coat 20.00 Shoes 45.00-65.00 Supplies for clinic ~200.00 Total $1,528.00+ Spring Semester: Books* $ 297.00 Drug Screen/Background check 50.00 (Required prior to first patient care experience) Gloves and masks ~ 75.00 Total $ 422.00 Summer Semester: Books* $ 126.00 Gloves and masks ~75.00 Total $ 201.00 SECOND-YEAR STUDENTS Fall Semester: Books* $ 112.00 SADHA dues 0.00 (Currently paid by Student Leadership Council) Scrub uniform (per set) ~25.00 Gloves and masks ~ 75.00 Board Review Course 399.00 (Not mandatory, but highly recommended) Total $ 662.00 Spring Semester: Books* $ 56.00 Gloves and masks ~ 75.00 National Board Examination fee 400.00 Clinical Examination fee 995.00 Georgia DHYG License 75.00 Total $1,601.00 Estimated Grand Total for all semesters: $4,784.00+ (Does not include CGTC tuition and fees) *Book expenses reflect DHYG (new) books only. FREQUENTLY ASKED QUESTIONS DENTAL HYGIENE What is a Dental Hygienist? A dental hygienist is a licensed healthcare professional that provides preventive, educational, and therapeutic services supporting total health for the control of oral diseases and the promotion of oral health. They inspect the mouth and remove deposits and stains from teeth. They obtain and process dental x-rays, counsel patients in dental health care, and work as a member of the dental team. Dental hygienists are graduates of accredited dental hygiene education programs in colleges and universities and must successfully pass both written and clinical board exams in order to practice. In addition to direct patient treatment, dental hygienists also work as educators, public health officials, researchers, and administrators. 8

Where do they work? Dental hygienists are employed in general and specialty dental practices, programs for research, professional education, community health, and hospital and institutional care of disabled persons, as well as federal programs, the armed services, and dental product promotion. What training is involved? Central Georgia Technical College Dental Hygiene programs accept dental hygiene students once a year. To begin the program, students must complete specific required general core courses at an accredited college or university. Central Georgia Technical College admits new students into the Dental Hygiene Program every semester to begin the required essential core courses. All core coursework must be successfully completed prior to acceptance into the program. Selection is competitive. Students who are selected by the North Campus will complete 6 semesters (four 15-week semesters and two 9-week semesters) of occupational courses. Students who are selected by the South Campus will complete 5 semesters (four 15-week semesters and one 9-week semester) of occupational courses. Exactly what will I study during this program? Following successful completion of the required general core courses and admission to the Dental Hygiene Program, students study Essential Fundamental Occupational Courses and Specific Occupational Courses such as Radiology, Head and Neck Anatomy, Oral Pathology, and Clinical Dental Hygiene. Students have the option of completing PSYC 1101, SOCI 1101, SPCH 1101 and COMP 1000 prior to admission, if desired. What happens after I finish the Dental Hygiene Program? Students who complete the Program earn a Dental Hygiene Associate Degree of Applied Science. Dental Hygienists are licensed professionals and are required to successfully complete the National Board Dental Hygiene Examination and a Regional or State License Examination. In the state of Georgia, students are required to pass the CRDTS Clinical Examination for Licensure. Passing the CRDTS exam will allow the student to practice in one of forty-four states in the United States. What will I earn as a Dental Hygienist? Current salaries for entry-level positions vary depending on the responsibilities associated with the specific position, the geographic location, and the type of practice or other setting in which the hygienist works. According to Salary.com, the median annual salary for a full-time dental hygienist in the Central Georgia area in 2013 was $62,000. The American Dental Association reported that, on average, hygienists in the U.S. who worked part-time averaged $30.01 per hour. Salary is influenced by employer size, location, industry, employee credentials, part/full-time status, and years of experience. Why should I choose CGTC? Central Georgia Technical College s Dental Hygiene programs offer state-of-the-art equipment for laboratory studies and advanced facilities for clinical training. On-site dental hygiene clinics have advanced computer equipment to prepare students for all phases of modern dentistry including digital radiography. CGTC faculty members are well-trained and involved in local, state, and national healthcare organizations. Students benefit from the close interaction with dental faculty. CGTC offers students superb educational opportunities without the high cost associated with post-secondary education. The statements in this publication are for informational purposes only and should not be construed as the basis of a contract between the student and the College. For more information about the DHYG program, please contact Dr. Barbara Jansen, (478)218-3244 at the Warner Robins Campus or Mrs. April Catlett, (478)-75-3487. For questions or to register to take the PSB Test ($20), contact the Testing Center: Warner Robins Campus: (478) 218-3390 Macon Campus: (478) 757-3515 INTRODUCTION 9

The Psychological Services Bureau (PSB) Health Occupational Aptitude Examination is an aptitude examination designed to measure a combination of abilities and characteristics essential for successful completion of the Dental Hygiene Program. Students requiring accommodations must request those accommodations before attempting the PSB exam. The exam consists of a battery of five timed tests which have been developed specifically for use by all allied health occupations education programs in admission, placement, and guidance procedures. The five tests include: Academic Aptitude This section of the examination is a test which provides the means for appraising an individual s capability to learn. It assesses the combination of inherent and acquired abilities needed for mastering scholastic work. It measures an applicant s strengths and weaknesses in three school-related abilities which are fundamental to learning: verbal, quantitative, and non-verbal skills. The Academic Aptitude test is a multiple factor test. It measures facility with verbal material, mathematics that deal with numbers, and manipulating spatial relationships. It also measures the applicant s ability to work accurately with some degree of speed. (75 questions/40 minutes) Spelling The spelling test measures spelling skills, a tool essential to written expression and communication. In the allied health professions, the written statement or expression will often assume more importance and take precedence over oral forms of communication information. The allied health education programs student will also have occasions when the exchange of ideas and opinions will be required in writing. The spelling test findings also reflect an examinee s educational achievement background in at least one of the basic tools of learning. (45 words/15 minutes) Reading Comprehension Reading Comprehension tests students ability to understand what they read. It provides measurement in eight comprehension skills: main thought, details, inferences, meaning of words from context, reading to retain information, organization, evaluation, interpretation, and appreciation. Passages are not limited to any specific subject matter area, but rather are varied for an adequate representation of textbook materials in a number of areas. (35 questions/35 minutes) Information in the Natural Sciences Measurement accomplished with the Information in the Natural Sciences test is concerned with the examinee s accumulation of information in the natural sciences. Some of the branches of sciences included are: biology, microbiology, chemistry, physics, pharmacology, anatomy, physiology, health and safety. A pattern of knowledge in this area can be related to and predictive of success in the allied health educational and occupational fields. (60 questions/25 minutes) 10

Vocational Adjustment Index This part of the test is an inventory of an individual s feelings, attitudes, and opinions. It is designed to assist in placing the examinee in a work situation where he/she will find satisfaction. Knowledge of various significant personality attributes is an important variable in assessing the qualifications necessary to successfully complete the education and training program. Feelings, attitudes, and opinions frequently determine success or failure. The index yields a composite estimate of the individual s typical coping and adapting behavior. (90 statements/15 minutes) ONLINE PSB TEST WORKSHOP Cape Fear Community College (CFCC) in North Carolina has developed an online workshop to prepare for the PSB test: http://cfcc.edu/learninglab/psb/psb.htm#tests Click on the following link for additional resources: http://www.centralgatech.edu/newtest/1/psb.asp Another resource recommended by the developers of the PSB test: Nursing School and Allied Health Entrance Exams (Arco Academic Test Preparation) by Arco, Marion F. Gooding Dental Hygiene Applicant Shadowing Form PLEASE FOLLOW THE SHADOWING GUIDELINES ON THE NEXT PAGE *If shadowing at more than one office, you may make multiple copies of this form. 40+ total shadowing hours are recommended. Applicant Name: Address: SHADOWING VERIFICATION 11

The applicant named above has completed hours of observation in this office on date(s). List the type of procedures observed: Comments (optional): Dental Hygienist(s) Observed: Printed Name Printed Name Printed Name Signature Signature Signature Office Address: Office Telephone: Please return this completed form to the Admissions Office at the Central Georgia Technical College campus of your choice: North Campus: 3300 Macon Tech Drive, Macon, GA 31206 or FAX: 478-757-3454 South Campus: 80 Cohen Walker Drive, Warner Robins, GA 31088 or FAX: 478-988-6947 Shadowing Guidelines Please observe the following guidelines for all your shadowing experiences. Appearance Professional appearance is very important! Wear scrubs. Wear closed-toed shoes. Hair should be pulled back. No fingernail polish. Nails must be trimmed. All visible tattoos must be covered. Remove all visible nose, eyebrow, tongue, and/or lip piercings. 12

Hair should be a natural color (No rainbow colors) Earrings, if worn, should not extend below the earlobe. No heavy makeup. Additional Guidelines No gum chewing. No cell-phone use. No smoking/recent smoking (the smell stays on you and your clothing). No offensive or strong perfume. Please bring a notebook and pen. Unless the provider encourages you to do so, do not ask questions while observing procedures. Write questions in your notebook to ask once the patient is dismissed. Bring protective eyewear. Be genuinely interested This will be your chosen profession! 13