Allan Hancock College 2014 2015 Medical Assisting Certificate Program Application Period: January 6 th March 31 st

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Application Period: January 6 th March 31 st Thank you for your interest in the Allan Hancock College Medical Assisting Certificate Program. We are pleased that you are exploring Medical Assisting as a profession. Medical Assisting is a demanding discipline and the course of study is challenging as well as rewarding. The application period begins in January and seating is based in order of complete application submission. Please review the contents of this application packet thoroughly prior to submitting your application and supporting documents. If you have questions regarding the Medical Assisting Certificate and/or specific questions about the application process contact the Health Sciences Department at 805 922 6966 ext. 3384. PROGRAM The Medical Assisting Certificate Program is a two semester program held during the day that provides essential skills that are needed for employment in a medical office. Student must provide proof of completion of high school/ged and must be 18 years of age or older. A physical, complete immunization record, drug screen and background check are required to be completed prior to the start of the program to be compliance with our medical facilities. A 3 week externship is required at the end of the spring semester. A grade of C or better in the medical assisting classes is required to progress in the program. EMPLOYMENT OPPORTUNITIES The median hourly wage is $15.00 per hour. A medical assistant may work in private practice such as a medical office. Other areas of employment include community clinics, government agencies including federal or state hospitals. CERTIFICATION OF COMPLETION Total of 26.5 units Allan Hancock College will offer a Certificate of Completion, once the student has completed the mandatory classes. 1 st semester 17 units (14 units if BUS 107 was taken prior) MA 305 Body Systems and Disease 5 MA 350 MA Fundamentals 2 MA 351 MA Clinical Procedures 3 MA 352 Medical Administrative Procedures 4 2 nd semester 12.5 units MA 353 Medical Assisting Clinical Procedures 5 MA 355 Pharmacology 4 MA 356 Job Success Externship 3.5 APPLICATION AND ADMISSION To apply for the Medical Assisting Program, you must submit a completed packet. Incomplete packets will not be accepted. Upon receipt of your completed packed, you will be placed on the list and assigned a position. Applications are available starting in October of each year and students will be notified by email when their application has been processed. The first 30 seats are assigned in order of the completed application submission. A waitlist will be maintained throughout the year, and all students who did not get a seat in the program will have first seating the following August upon reapplication. APPLICATION ELIGIBILITY CRITERIA High School Graduate/GED Certificate 18 years of age or older START Scores (For testing out of English and/or Math) Students must test out of ENG 514 and/or MATH 531 to be eligible to use scores as equivalency. Must complete the following classes with a grade C or better or show equivalency. o CBIS 101 (no testing out method available) o Math 531 OR Start Scores o ENG 514 OR Start Scores COMPLETED APPLICATION CONSISTS OF: Completed Program Application Form Completion of high school/ged by providing a copy of high school transcript or GED certificate. Your AHC student profile (found on the myhancock portal, under Student Tab, link labeled non official transcript ). This will also provide us with your START placement score, required for eligibility. Copies of previous college transcripts (if using a course to show equivalency for pre requisites. You may hand deliver your packet to the Health Sciences office (M132) on the Main Campus or mail to: Attn: Health Sciences Department, 800 S. College Drive, Santa Maria, CA 93454. UPON ACCEPTANCE A formal letter will be sent out the 3 rd week of May, to students seated in the upcoming class containing an acceptance letter. This acceptance letter must be completed and turned into the Health Sciences office by the specified date.

Items (Background Check, Immunizations, Physical Form, Drug Screening, Acknowledgement of Potential Risk/Substance Abuse Testing Form, ) that are contained within the Acceptance Letter Packet will be required to be completed and handed into the Health Sciences Office (M 132) by July 24, 2014 It is the responsibility of the student to register and pay for all the Medical Assisting (MA) Classes held in each semester. ABSENT AND TARDY POLICY Two (2) days absence per class are allowed for the entire semester. Three (3) tardies are considered a full day s absence. If you are not present when role is called, you are tardy. More than 30 minutes late is considered a full day s absence. Missing 30 minutes or more during ANY part of class is considered a full day s absence. Do not make appointments during class time. There is no such thing as an excused absence. FINANCIAL AID Assistance with registration fees and supplies please contact the Financial Aid office (x3216). CPR CARD The CPR card that is required is Healthcare Provider (American Heart Association) OR Professional Rescuer (American Red Cross) OR EMS 306 (AHC). This card must be kept current and cannot expire during the program. DRESS CODE Your appearance reflects the hospital and college standards and indicates to patients and co workers your pride and interest in your profession. These standards are maintained by personal neatness and cleanliness, by wearing only the authorized uniform and by avoiding the use of elaborate jewelry and cosmetics. You are encouraged to wear your uniform on the first day of class. It is MANDATORY that you are in full uniform, including the name tag, by the second day of class. There will be a uniform/dress code check on that day. All other grooming and piercing policies will be enforced when class begins. Uniforms may be purchased anywhere, Uniforms & More is highly recommended (722 E Main Street, Suite 109 Santa Maria, CA 93454, 805.928.6513) as long as they comply with the following dress code: 1. Uniform Shirt/Top Solid burgundy: Scrub type top with/without pockets, zip or snap front. The uniform shirt/top must fit freely over hips and be 2 to 4 inches below buttocks. 2. Pants Burgundy: The pants must fit loosely over knees and thighs. Jeans or stretch pants are not allowed. The length must be long enough to cover the top of shoe at the heel when standing. Free from stains or wrinkles. 3. Sweater White: Button Up or Zip with ¾ sleeve. The sweater is not required. If purchased, make sure it is machine washable. The sweater is not allowed when giving direct patient care. 4. Shoes/socks White leather shoe. Closed toe and heel required. No clogs. White socks. Neutral hose. 5. Watch You MUST have a watch with a seconds hand (NOT digital) 6. AHC Student ID Card with picture: Must be worn with the identification name pin. You will not be allowed to work at the facilities without a picture ID. 7. Jewelry: You may wear an engagement or wedding ring on left hand only, and plain post earrings (only one earring per earlobe). Rings that are a hazard to patient care will be removed. No other visible piercings are allowed (tongue, nose, eyebrow, etc.) 8. Nails must be cut so as not to be seen from palm side of hand. They must be clean and filed. Clear nail polish only. 9. Hair must be clean, contained and neat. If it touches your nose you must wear it up. If the ponytail or braid touches your nose it must be worn up. 10. Makeup to a minimal, and in good taste for daytime wear. 11. No perfume. 12. Tattoos must be covered. ** Please remember to make a copy of your entire application packet prior to turning it in. Copies will not be made at the Health Sciences Office. Copy machines can be found at the library or at campus graphics.

Application Period: January 6 th March 31 st DISQUALIFYING PENAL CODES IMPORTANT: It is the responsibility of the facilities to hold students to the same standards as an employee who has patient contact. The facilities have the final say as to whether a student may participate in patient care. It is not the decision of Allan Hancock College. Infractions, probations or pending court cases showing up on backgrounds may result in nonadmittance to or dismissal from the program. Felony convictions will result in non admittance to the program. If you have been convicted of a penal code not listed and are unsure of eligibility please call the Health Sciences Office (805) 922 6966 ext. 3384. It may take several weeks to complete the background check. You will be dropped if the background check is not started between June 1 st July 31 st and completed prior to August 9, 2014. **BACKGROUND CHECKS: The Joint Commission of Hospital Accreditation has required that any person having patient contact be screened for criminal convictions, and the results must be available to the care facility (ACUTE CARE). The results of Live Scan fingerprinting cannot go to the facility, making it necessary to perform a second screening through Corporate Screening Services, Inc.

Disqualifying Penal Code Sections If applicants have been convicted of any of the penal codes listed, CNA/HHA applicants will be automatically denied certification or ICF/DD, DDH OR DDN applications will be denied employment. Section 187 Murder 192(a) Manslaughter, Voluntary 203 Mayhem 205 Aggravated Mayhem 206 Torture 207 Kidnapping 209 Kidnapping for ransom, reward, or extortion or robbery 210 Extortion by posing as kidnapper 210.5 False imprisonment 211 Robbery (includes degrees in 212.5 (a) and (b)) 220 Assault with intent to commit mayhem, rape, sodomy, oral copulation 222 Administering stupefying drugs to assist in commission of a felony. 243.4 Sexual battery (includes degrees (a) - (d)) 245 Assault with deadly weapon, all inclusive 261 Rape (includes degrees (a) - (c)) 262 Rape of spouse (includes degrees (a) - (e)) 264.1 Rape or penetration of genital or anal openings by foreign object 265 Abduction for marriage or defilement 266 Inveiglement or enticement of female under 18 266(a) Taking person without will or by misrepresentation for prostitution 266(b) Taking person by force 266(c) Sexual act by fear 266(d) Receiving money to place person in cohabitation 266(e) Placing a person for prostitution against will 266(f) Selling a person 266(g) Prostitution of wife by force 266(h) Pimping 266(i) Pandering 266(j) Placing child under 16 for lewd act 266(k) Felony enhancement for pimping/pandering 267 Abduction of person under 18 for purposes of prostitution 273(a) Willful harm or injury to a child (includes degrees (a) - (c)) 273(d) Corporal punishment/injury to a child (includes degrees (a) (c)) 273.5 Willful infliction of corporal injury (includes (a) (h)) 285 Incest 286(c) Sodomy with person under 14 years against will 286 (d) Voluntarily acting in concert with or aiding and abetting in act of sodomy against will 286 (f) Sodomy with unconscious victim 286 (g) Sodomy with victim with mental disorder or developmental or physical disability 288 Lewd or lascivious acts with child under age of 14 288a(c) Oral copulation with person under 14 years against will 288a(d) Voluntarily acting in concert with or aiding and abetting 288a(f) Oral copulation with unconscious victim 288a(g) Oral copulation with victim with mental disorder or developmental or physical disability 288.5 Continuous sexual abuse of a child (includes degree (a)) 289 Penetration of genital or anal openings by foreign object (includes degrees (a) (j)) 289.5 Rape and sodomy (Includes 289.6 degrees (a) and (b)) 368 Elder or dependent adult abuse; theft or embezzlement of property (includes (b) (f)) 451 Arson (includes degrees (a) (e)) 459 Burglary (includes degrees in 460 (a) and (b)) 470 Forgery (includes (a) (e)) 475 Possession or receipt of forged bills, notes, trading stamps, lottery tickets or shares (includes degrees (a) (c)) 484 Theft 484b Intent to commit theft by fraud 484d-j Theft of access card, forgery of access card, unlawful use of access card 487 Grand theft (includes degrees (a) (d)) 488 Petty theft 496 Receiving stolen property (includes (a) (c)) 503 Embezzlement 518 Extortion 666 Repeat convictions for petty theft, grand theft, burglary, carjacking, robbery and receipt of stolen property

2014 2015 Medical Assisting Program Application Application Period: January 6 th March 31 st Personal Information Full Name: Address: Last First M.I. Street Address Apartment/Unit # City State ZIP Code Home Phone: ( ) Alternate Phone: ( ) SS#: Birth Date: AHC Student ID# H Email Address: Are you a high school graduate? Date of Graduation If not, When did you receive a GED certificate? Other Questions (Not mandatory) Date of GED Have you previously attended AHC? YES NO If yes, Did you take the START Test? YES NO Are you currently employed in a medical office: YES NO Part Time Full Time By checking all the boxes and providing your signature: I will complete mandated items and turn in copies of forms, etc. as detailed in this application packet. I agree to submit proof of completion (or equivalency) of MATH 531, ENG 514 and CBIS 101 with a grade C or better to the Health Sciences office with this application. Both transcripts and/or START assessment test scores are accepted. I agree that I must submit proof that I am 18 years of age or older for the block to be removed for the Medical Assisting Program. I understand that the physical, proof of immunizations, background check and drug screening are required by the facilities and not by Allan Hancock College. Infractions, probations or pending court cases showing up on the background check and/or a positive drug screen test may result in non admittance to or dismissal from the program. I understand that I must complete all Medical Assisting Classes and submit proof of completing BUS 107 with a grade of C or better by the last day of the fall semester to remain in the Medical Assisting Program for the Spring semester. I understand that the mandatory items packet must be submitted to the Health Sciences Offices by July 24, 2014 at 10am. Failure to do so will result in being dropped from the program. Please contact the Health Sciences office for alternate arrangements prior to July 24 th, if needed. If on the waitlist, I understand that I will be contacted after August 8 th (unless a seat has become open prior to) depending on seat availability. It is my responsibility to complete the packet within the timeframe specified upon notification. I agree to the application process, completion of certificate guidelines, Absent and Tardy policy, and any other detailed information provided in this application packet. Signature Date Submitting an application does not guarantee that applicants have satisfied minimum criteria. Completed Application Packet (as detailed in this packet) is due in the office (M132) by March 31, 2014 No exceptions will be made! 5

For Office Use Only Last Name Student Requirements Check Off List H Application and Prerequisites Completed: Completed Program Application AHC unofficial transcript ENG 514 or START Test English Score (221 ) MATH 531 or START Test Math Score (53 ) CBIS 101 The following items must be completed prior to acceptance in the program: Acceptance Letter Packet Sent Acceptance Statement Received Physical Examination TB Expiration Date Immunizations DPT MMR Varicella HEP B Healthcare CPR certified Expiration Date Background Check Drug Screening Fall Courses Completed: MA 305 MA 350 MA 351 MA 352 Spring Courses Completed: MA 353 MA 355 MA 356 The following items must be completed after completion of all courses Completed Certificate of Completion 6

Application Period: January 7 th March 31 st 2014 2015 ESTIMATED PROGRAM STUDENT FEES The following is a list of approximate costs of the Medical Assisting Program. Prices are subject to change. Pre ENROLLMENT EXPENSES Physical Exam private physician (Between June 1 July 31) Variable Cost Immunizations Hep B Series, Varicella, DPT, MMR, Flu Vaccine, TB Variable Cost Background Check Corporate Screening (Between June 1 July 31) $48.00 Drug Screening ROBLAR(Between June 1 July 31) $30.00 AHC Student ID card with picture $3.00 Mandatory Courses CPR for healthcare providers EMS 306 (½ unit) + $21 textbook (cost vary elsewhere) $13.00 + $21.00 (AHC) FALL SEMESTER TOTAL FALL SEMESTER COSTS $1550.00 Registration (14 units @ $36/unit) $504.00 Parking $20.00 Health Fee $14.00 Student center fees plus student representation fee $14.00 REQUIRED FALL TEXTBOOKS $500.00 (est.) IDENTIFICATION NAME PIN $10.00 UNIFORMS $200.00 SHOES $50.00 FALL SKILLS KIT Grace Training Supplies, order by August 1, 2012) $90.00 (est.) WATCH (Not digital, must have seconds hand) $30.00 STETHOSCOPE (Prestige Medical/Littman s recommended) $30.00 ANEROID SPHYGMOMANOMETER (Prestige Medical/Littman s recommended) $30.00 Miscellaneous Supplies flash drive, notebooks, pens, paper $55.00 SPRING SEMESTER TOTAL SPRING SEMESTER COSTS $1073.00 Registration (12.5units @ $36/unit) $450.00 Parking $20.00 Health Fee $14.00 Student center fees plus student representation fee $14.00 REQUIRED SPRING TEXTBOOKS $300.00 (est.) SPRING SKILLS KIT Grace Training Supplies, order by December 1, 2012) $70.00 (est.) EXTERNSHIP COSTS (estimated transportation/gas costs) $150.00 Miscellaneous Supplies flash drive, notebooks, pens, paper $55.00 TOTAL ESTIMATED COSTS TO ACHIEVE MEDICAL ASSISTING CERTIFICATE (Does not include Pre Enrollment Expenses due to the variable costs) $2,728.00 7