Oregon State University School of Biological and Population Health Sciences KIN 344: Pre-Therapy/Allied Health Practicum.

Size: px
Start display at page:

Download "Oregon State University School of Biological and Population Health Sciences KIN 344: Pre-Therapy/Allied Health Practicum."

Transcription

1 KIN 344: Pre-Therapy/Allied Health Practicum Checklist Obtain application packet and read all enclosed information Complete the Application Form Complete the Immunization Form Attach copies of medical record documenting your immunizations. Complete the Code of Conduct Form Attach unofficial transcripts Turn in application to the advising office for signature. If your overall GPA is < 3.20 you should schedule an appointment with your academic advisor. Applications with overall GPA < 3.2 without an advisor signature indicating you have had a meeting will not be considered. Submit your KIN 343 and KIN 344 applications. Applications should be submitted to in the mailbox for. If your application is submitted after the due date, it should be date stamped by the department office in Milam 101. Register for KIN 343 and KIN 344 once cleared by instructor/department After registration, complete the Blood Borne Pathogens Forms available on blackboard Once you receive information regarding placement, contact your clinical site Attend the first day of classes - MANDATORY DUE DATE FOR Term:

2 KIN 344/345 Pre-Therapy/Allied Health Practicum Information Sheet The Pre-Therapy/Allied Health Practicum is designed to provide the student with an opportunity to work with a member of the allied health community in the student s desired area of interest. Below is a list of the student expectations. The specific requirements for the grading of this practicum will be provided to you on the first day of class. Eligibility and authorization for registration for KIN 344 is made by the instructor of the course. Junior and Senior level students are eligible under the following criteria: o You have completed the anatomy and physiology series successfully ( C or greater) o You have completed the anatomy and physiology series with a composite GPA of 2.70 or greater o You have maintained at least a 2.5 in all EXSS/KIN coursework o You have maintained at least a 2.25 in all option coursework and supporting coursework (not bac core) o You have maintained an overall GPA of 3.0 o You have completed an application and have provided all of your immunization information including copies of medical record documenting all immunizations o You have been tested for Tuberculosis (Tb) within the last calendar year. It must remain current throughout your affiliation time. KIN 343 and EXSS 344 are to be taken concurrently. KIN 343 is your seminar course and KIN 344 is the practicum course. You will be expected to obtain 50 hours with your clinical supervisor during the term you register for the course which works out to be approximately 5 hours per week. It is up to you and the allied health professional to determine a schedule that is acceptable. You are expected to dress and behave in a professional manner at all times; this includes (1) closed toe shoes, (2) business, professional dress including khaki or dark colored pants, a collared shirt that can be tucked into your pants, (3) no perfume or cologne, (4) no facial jewelry, and (5) men should maintain facial hair nicely groomed. Do not bring personal items with you to your clinical rotation. All you will need is a pen and some paper for notes to be taken during your observation. Please contact your clinical supervisor if you are sick to make up hours. Patients in the acute care or skilled nursing settings may have compromised immune systems and are at risk for infection. Follow-all rules of the facility. Maintain patient confidentiality at all times. If additional students are located at your facility, limit chit-chat to outside of your affiliation. MANDATORY ATTENDANCE ON THE FIRST DAY OF CLASSES.

3 Pre-Therapy/Allied Health Practicum Practicum Guidelines The following guidelines will be expected during your clinical affiliation. Any violation of the below listed guidelines are reason for dismissal from your clinical experience and issuing of a failing grade. 1. Confidentiality. Patient treatment and records are currently under confidentiality laws. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates patient confidentiality. Patients, their treatment, their medical history, and personal information CANNOT be discussed outside of the clinic setting and only with clinic personnel. Patients should be asked for their permission prior to your observation by the supervising clinician. Some patients may refuse to have students observe and therefore, you may be asked to leave the room. Do not feel offended. 2. Dress Code. Whether you are in close, daily contact with patients or in a behind the scenes job, you represent the company to which you are observing as well as Oregon State University. The way you look, dress and act is just as vitally important. For this reason, grooming and apparel appropriate for a professional atmosphere is expected and any deviation from this will not be tolerated. Apparel is acceptable if it can be: (1) easily considered in good taste and could not be offensive to a reasonable person, (2) functional to allow the intern to perform various activities including laundry, cleaning and demonstration of activities. It is expected that students fulfilling internship requirements dress in: casual business attire which generally implies khaki or black slacks appropriate button down or polo shirt which can easily be tucked in for a more professional look. The shirt should be of sufficient length to be tucked in and remained tucked in when engaging in routine duties. closed toe shoes Inappropriate dress includes such things as: apparel such as tight pants or extremely saggy pants bare midriffs casual attire such as jeans, T-shirts and open toed shoes Facial hair and jewelry should be in good taste. Facial hair should be well-groomed and facial jewelry should be removed. Some older patients find facial jewelry very offensive. If you have any doubts about your personal dress, please err on the side of caution and choose a different attire. Inappropriate dress is reason for a student intern to be dismissed from their duties for the day and multiple episodes of inappropriate dress is reason for a failing grade. 3. Name Tag. Each student completing a clinical practicum experience will be expected to obtain a name badge from the ID center prior to starting their clinical placement. 4. Punctuality. Please be on time. Because most clinicians see a new patient every ½ hour, it is important that you are there to see the initiation of the treatment, assessment, evaluation. 5. Questions. As a student intern, your supervisor is expecting that you will have some questions. It is a vital component to your learning process. However, use good judgment when asking questions in front of a patient. It is usually better to wait until you are in the staff office or away from patients before asking certain questions. 6. Duties. In exchange for the learning environment and the opportunity to observe patients, you may be asked to perform some light housekeeping duties. These duties are a timesaver for the staff. However, try not to let it be done in exchange for possible learning situations. If you see a table that needs to be cleaned or a pile of towels that need to be folded and you are not currently engaged in a learning situation, then please take the initiative and help out as needed. However, if you feel that you are performing too many housekeeping duties and not enough observation, then communicate with your supervisor that you would like to sit in with them while they treat, evaluate, assess their next patient. 7. Contact. You should be assigned to 1-2 clinical supervisors. If you have any questions, please feel free to speak with them. If you are having difficulty with your affiliation, please contact the course instructor BEFORE there is a problem.

4 School of Biological & Population Health Sciences KIN 344/345: Pre-Therapy/Allied Health Practicum Practicum Site Request Form (Student must be Junior or Senior Standing) Applicant Information (PLEASE COMPLETE IN BLACK OR BLUE PEN PENCIL IS NOT ACCEPTABLE) (Term) (Circle One) Major: Anticipated Graduation : Student ID Number: City: State: Phone: ONID *Your ONID account is considered your official address. If you do not have an ONID account, please register for one. Permanent Address: (Please complete if your home address is different than your local address) City: State: Practicum Information qq Occupational Therapy qq Physical Therapy qq Acute Care/In-patient qq Orthopedics/outpatient qq Pediatrics qq Rehabilitation/Skilled Nursing qq Other (please specify) qq qq qq qq qq qq Monday qq Tuesday qq Wednesday qq Thursday qq Friday Student Signature

5 KIN 344: Pre-Therapy/Allied Health Practicum Immunization Record Student Information Name: Term: Sr (Circle One) Local Address Address: City: Phone: Zip: ONID *: Major: Anticipated Graduation : Immunization Information PLEASE ATTACH COPIES OF YOUR MEDICAL RECORD DOCUMENTING YOUR IMMUNIZATIONS AND YOUR CURRENT TB CLEARANCE. This is required for application to the Practicum Course. TB clearance must remain current during the term of your practicum experience. of Birth Measles, Mumps, Rubella (MMR). Exempt from MMR requirement if born prior to st MMR: 2 nd MMR: _ () () Titer Results: Titer Results: ( Rubella/Rubeola) +/- ( Rubella/Rubeola) +/- Hepatitis B Vaccine 1 st Dose: Institution: 2 nd Dose: Titer: 3 rd Dose: () +/- rr I have not received the Hepatitis B Vaccine. Please read and initial below. I understand that due to potential exposure to blood or other infectious materials I may be at risk of acquiring Hepatitis B virus (HBV) infection. It is recommended that I receive the Hepatitis B vaccine prior to my clinical experience; however, I decline the Hepatitis B vaccination at this time. I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease. If, in the future, I continue to have occupational exposure to blood or other potentially infectious materials I can be vaccinated with Hepatitis B vaccine at that time. If unable to have vaccine due to medical reasons, please provide explanation on a separate sheet of paper. initial Ki

6 Name: Term: Chicken Pox Have you had Chicken Pox? rr YES rr NO If YES, of Disease If NO, s of Vaccine: Vaccine #1 Vaccine #2 Titer +/- Tuberculosis (TB) Have you had a TB Test within the last 12 months? rr YES rr NO MUST ATTACH PROOF TB Skin Test : mm/induration Have you ever had a positive TB test? rr YES* rr NO If yes, date of last chest x-ray and results *You will need to complete the TB Risk Factor Screening Form Have you ever completed preventative drug therapy (INH)? If yes, in what year? Tetanus Diphtheria and Pertussis (Tdap). This is a 1-time injection which updates all previous tetanus and Diphtheria (Td). Some affiliations recommend all health care workers with direct patient care be immunized against Pertussis. If you do not have the updated immunization, you will be requested to obtain this prior to starting your affiliation. : Institution: I attest the information provided is true, complete, and accurate to the best of my knowledge. Signature of Student Signature of Practicum Coordinator Please Return to: Coordinator, Pre-Therapy/Allied Health Practicum Oregon State University Langton 221 Corvallis, OR Ki

7 Pre-Therapy/Allied Health Practicum Code of Conduct Agreement My signature below indicates that I accept the Policies and Procedures of the Pre-Therapy/Allied Health Practicum at Oregon State University. Initial each statement below. I will abide by all policies and procedures of the Pre-Therapy/Allied Health Practicum as explained to me including dress code and code of conduct. I understand that I will need to obtain clinical observation experience in the Pre-Therapy/Allied Health Field. (KIN 344/345 = 50 hours). I understand that I may be placed in any of the Pre-Therapy/Allied Health Practicum experiences associated with KIN 344/345 according to my area of interest. Even though I may be asked for input regarding my clinical assignments, the final decisions for these assignments is the responsibility of the program s administration (depending on clinical site availability). I understand that there is no financial support associated with travel to and from clinical assignments associated with the Pre-Therapy/Allied Health Practicum. I understand that if I am injured while in attendance at a clinical assignment, unless it is determined the clinical site was negligent, my medical bills may not be covered. Oregon State University views off-site practicum experiences in the same manner as on-campus lab settings. Specifically, it is my responsibility to maintain personal health coverage during my clinical experience. I understand that I will need to obtain TB clearance and proof of immunization prior to being placed for my clinical assignment. I understand that I will need to make-up my missed clinical hours within one week of my absence so as to not bombard the clinical staff at the end of the term. I understand that I will need to maintain patient confidentiality both during and after the completion of my clinical experience. I understand that it is my responsibility to communicate with my clinical supervisor prior to arrival to obtain information regarding policies and procedures of the clinical site. I understand that it is my responsibility to communicate with the practicum coordinator any difficulties associated with a practicum experience in a timely manner. Student Signature OSU Practicum Coordinator Signature Ki

Internship Application x2645

Internship Application x2645 Internship Application 978-683-4000 x2645 Office Use Only Application Received Interview Orientation CORI TB1 TB2 Pin # Entered in Volgistics FLU PERSONAL INFORMATION First Name Last Name Street Address

More information

Please feel free to contact me at (410) if you have any questions regarding your application. Thanks again for thinking of Sinai Hospital!

Please feel free to contact me at (410) if you have any questions regarding your application. Thanks again for thinking of Sinai Hospital! July 2017 Dear Student, Thank you for your interest in Sinai Hospital s Student Fall Volunteer Program! As a healthcare family dedicated to our community, we are excited to help facilitate your hands-on

More information

*** Program Guidelines ***

*** Program Guidelines *** *** Program Guidelines *** *The Junior Volunteer program has a limited number of available positions. Placement decisions will be based upon first come, first serve. Volunteers must be at least 15 years

More information

Applicant Name (Please print) Last First MI. Northeast State Community College assigned Student ID Number: City: State: Zip Code:

Applicant Name (Please print) Last First MI. Northeast State Community College assigned Student ID Number: City: State: Zip Code: Applicant Information (Please note application must be completed in ink.) Applicant Name (Please print) Last First MI Northeast State Community College assigned Student ID Number: Street Address: PO Box:

More information

CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Fall 2016 Application

CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Fall 2016 Application CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Fall 2016 Application TO: FROM: Prospective EMT-Paramedic Student Dan Word MSHS, EMT-P Director Paramedic Education SUBJECT: Fall 2016 Paramedic Program (Class 87)

More information

Shadow-a-Professional Program 2016 Application

Shadow-a-Professional Program 2016 Application Thank you for your interest in The Shadow-A-Professional program that allows high school junior and senior students interested in the hospital industry to explore career options and/or gain experience

More information

MSU-Crowder Bachelor of Science in Nursing (BSN-C) Scholars Program.

MSU-Crowder Bachelor of Science in Nursing (BSN-C) Scholars Program. Dear Prospective Student: Thank you for your inquiry regarding the MSU-Crowder Bachelor of Science in Nursing (BSN-C) Scholars Program. This program is the result of an exciting collaboration between Crowder

More information

Emergency Medical Technician. Student Manual Courses 1119, 1119L and 1431

Emergency Medical Technician. Student Manual Courses 1119, 1119L and 1431 Emergency Medical Technician Student Manual Courses 1119, 1119L and 1431 Course Goals: These courses combined are designed to instruct the student to the level of Emergency Medical Technician, who serves

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

BINGHAMTON UNIVERSITY DECKER SCHOOL OF NURSING Student Health Requirements

BINGHAMTON UNIVERSITY DECKER SCHOOL OF NURSING Student Health Requirements BINGHAMTON UNIVERSITY DECKER SCHOOL OF NURSING Student Health Requirements This document includes information regarding: Student health evaluation form Documentation of immunity to communicable diseases

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

DEPN AND GRADUATE NURSING MANDATORIES INFORMATION

DEPN AND GRADUATE NURSING MANDATORIES INFORMATION DEPN AND GRADUATE NURSING MANDATORIES INFORMATION INITIAL MANDATORIES DUE AUGUST 15, 2018 Pre Clinical Mandatories Form If you have a first time positive PPD, include a radiology report If you have a history

More information

CRITICAL REQUIREMENTS FAQs Press control and click on the question to follow the link to the answer.

CRITICAL REQUIREMENTS FAQs Press control and click on the question to follow the link to the answer. CRITICAL REQUIREMENTS FAQs Press control and click on the question to follow the link to the answer. Table of Contents 1) What are the changes to the critical requirements?... 3 2) What cohorts are affected?...

More information

Applicant Name: First Middle Last. Age: Birth Date: Applicant Cell Phone: Address Phone: Number & Street Name City Zip Code

Applicant Name: First Middle Last. Age: Birth Date: Applicant Cell Phone: Address Phone: Number & Street Name City Zip Code PLEASE PRINT : Applicant Name: First Middle Last Age: Birth : Applicant Cell Phone: Address Phone: Number & Street Name City Zip Code (Applicant s) E-mail address: / Applicant s Parent s Legal Guardian/Mother/Father

More information

CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Spring 2019 Application

CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Spring 2019 Application CRAFTON HILLS COLLEGE PARAMEDIC PROGRAM Spring 2019 Application To: FROM: Prospective Paramedic Student Kathy Crow, BVE, EMT- P Director, Paramedic Education SUBJECT: Spring 2019 Paramedic Program (Class

More information

MEDICAL LABORATORY SCIENCE MANDATORIES INFORMATION

MEDICAL LABORATORY SCIENCE MANDATORIES INFORMATION MEDICAL LABORATORY SCIENCE MANDATORIES INFORMATION FIRST YEAR MANDATORIES HIPAA/OSHA Training You will complete your training through the Evolve e Learning Solutions website. You will receive an email

More information

Student Health Form Howard Community College Health Science Division

Student Health Form Howard Community College Health Science Division Name: HCC ID#: Student Health Form Howard Community College Health Science Division Student- Check program: Nursing: Fall: PN RN Day E/W Spring Accelerated Pathways (NURS-103) CVT: Dental Hygiene: MLT:

More information

Clinical Education Policies

Clinical Education Policies 1 Clinical Education Policies Table of Contents Assignment of Students Page 1 Student Information Page 1 Student Information Form Page 2 Reasonable Accommodations Request Student Health Form Pages 3-5

More information

Applicant: Student ID Date:

Applicant: Student ID Date: Applicant: Student ID Date: Home Phone: Cell Phone: E-mail: Must attach documentation (copies of lab reports, immunization records, and CPR card) as indicated for each of the following to be in compliance

More information

NURSING ASSISTANT ADVANCED PLACEMENT PROGRAM REGISTRATION PACKET AND INFORMATION

NURSING ASSISTANT ADVANCED PLACEMENT PROGRAM REGISTRATION PACKET AND INFORMATION NURSING ASSISTANT ADVANCED PLACEMENT PROGRAM REGISTRATION PACKET AND INFORMATION Classes are offered at the following locations: Superstition Mountain Campus Signal Peak Campus Maricopa Campus San Tan

More information

ADMISSION PACKET. School of Nursing BSN - DNP Program

ADMISSION PACKET. School of Nursing BSN - DNP Program ADMISSION PACKET School of Nursing BSN - DNP Program The Doctor of Nursing Practice (DNP) program at Kentucky State University is a 72 credit hours (9 semesters) BSN-DNP online program with emphasis in

More information

NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION

NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION NURSING ASSISTANT PROGRAM REGISTRATION PACKET AND INFORMATION Must be received 10 days prior to the start of class to be admitted for the semester. Classes are offered at the following locations: Superstition

More information

Bonnie Butler-Sibbald. Dear Volunteer Applicant:

Bonnie Butler-Sibbald. Dear Volunteer Applicant: VOLUNTEER SERVICES Telephone (818) 409-7781 Facsimile Dear Volunteer Applicant: Thank you for your interest in the volunteer opportunities at Glendale Memorial Hospital and Health Center (GMHHC). Please

More information

MOLLOY COLLEGE THE BARBARA H. HAGAN SCHOOL OF NURSING. CHECKLIST Everything must be completed

MOLLOY COLLEGE THE BARBARA H. HAGAN SCHOOL OF NURSING. CHECKLIST Everything must be completed : MOLLOY COLLEGE CHECKLIST Everything must be completed 1. PHYSICAL EXAMINATION, completed on a School of Nursing Physical Form. Must be signed, stamped and dated by a Health Care Provider and include:

More information

Le Bonheur Children's Hospital Child Life Clinical Internship Program

Le Bonheur Children's Hospital Child Life Clinical Internship Program Le Bonheur Children's Hospital Child Life Clinical Internship Program The child life clinical internship is a concentrated 16-week (640 hours) placement within the health care system where qualified students

More information

Student Health Form Howard Community College Health Science Division

Student Health Form Howard Community College Health Science Division Name: HCC ID#: Student Health Form Howard Community College Health Science Division HEALTH FORM DEADLINES Completed Health Form must be submitted prior to the following dates. Late submissions may result

More information

Guide to CastleBranch

Guide to CastleBranch Guide to CastleBranch CastleBranch / CB: https://www.castlebranch.com/ Prior to beginning practicum courses, students must provide documentation that they have met certain requirements through CastleBranch,

More information

MOLLOY COLLEGE Barbara H. Hagan School of Nursing

MOLLOY COLLEGE Barbara H. Hagan School of Nursing New Clinical Student Checklist MOLLOY COLLEGE Barbara H. Hagan School of Nursing The following is a checklist of requirements for attending clinical practice Hospitals and Community Agencies. Each item

More information

CLINICAL EXPERIENCES DEPARTMENT OF PHYSICAL THERAPY

CLINICAL EXPERIENCES DEPARTMENT OF PHYSICAL THERAPY CLINICAL EXPERIENCES DEPARTMENT OF PHYSICAL THERAPY 2 TABLE OF CONTENTS Clinical Experiences... 3 Clinical Experiences 2nd Year... 3 Clinical Experiences 3rd Year... 3 Clinical Site Selection... 4 Assignments...

More information

Le Bonheur Children's Hospital Child Life Practicum Program

Le Bonheur Children's Hospital Child Life Practicum Program Le Bonheur Children's Hospital Child Life Practicum Program The child life practicum is a minimum of 100 hours of observation within the health care setting where qualified students gain practical knowledge

More information

Date: Name: (Last) (First) (Middle) Address: (Street) (City) (State) (Zip Code) Current Age: Date of Birth: Phone: cell:

Date: Name: (Last) (First) (Middle) Address: (Street) (City) (State) (Zip Code) Current Age: Date of Birth: Phone: cell: Children s Hospital Junior Ambassador Program Application Packet for Summer 2018 Dates of Program June 11th through July 27th, 2018 Application Deadline March 5, 2018 Date: Name: (Last) (First) (Middle)

More information

Job Shadow Program Guidelines

Job Shadow Program Guidelines Job Shadow Program Guidelines The Job Shadow Program is intended for those who have an interest in learning more about health care professions. Shadowing allows the participant to follow and observe a

More information

Davidson Campus: P.O. Box 1287, Lexington, NC Telephone: FAX:

Davidson Campus: P.O. Box 1287, Lexington, NC Telephone: FAX: Davidson Campus: P.O. Box 1287, Lexington, NC 27293-1287 Telephone: 336-249-8186 FAX: 336-249-0088 Davie Campus: 1205 Salisbury Road, Mocksville, NC 27028 Telephone: 336-751-2885 FAX: 336-751-6192 TO:

More information

DMACC INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD

DMACC INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD DMACC DES MOINES AREA COMMUNITY COLLEGE INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD Health and Public Service Department Students need to complete and submit the Student Health and

More information

Allan Hancock College 2019 Licensed Vocational Nursing Program Application Period: April 1 st June 30 th, 2018

Allan Hancock College 2019 Licensed Vocational Nursing Program Application Period: April 1 st June 30 th, 2018 *This application is for applicants who currently have an LVN waitlist number* It is the responsibility of the student to complete this application packet and turn it into the Health Sciences Department

More information

Ambassador Program Application Packet

Ambassador Program Application Packet Ambassador Program Application Packet Thank you for your interest in becoming an Ambassador at Centinela Hospital Medical Center. Please complete the attached forms and then contact the Centinela Hospital

More information

Le Bonheur Children's Hospital Child Life Clinical Internship Program

Le Bonheur Children's Hospital Child Life Clinical Internship Program Le Bonheur Children's Hospital Child Life Clinical Internship Program The child life clinical internship is a concentrated 16-week (640 hours) placement within the health care system where qualified students

More information

THE 2014 AMERICAN RED CROSS SUMMER YOUTH VOLUNTEER PROGRAM AT THE EVANS ARMY COMMUNITY HOSPITAL FORT CARSON, COLORADO May 27 July 25

THE 2014 AMERICAN RED CROSS SUMMER YOUTH VOLUNTEER PROGRAM AT THE EVANS ARMY COMMUNITY HOSPITAL FORT CARSON, COLORADO May 27 July 25 THE 2014 AMERICAN RED CROSS SUMMER YOUTH VOLUNTEER PROGRAM AT THE EVANS ARMY COMMUNITY HOSPITAL FORT CARSON, COLORADO May 27 July 25 The American Red Cross (ARC) at Fort Carson s Evans Army Community Hospital

More information

If you would like to volunteer in the Gift Shop as part of the Hospital Auxiliary, please call for additional information.

If you would like to volunteer in the Gift Shop as part of the Hospital Auxiliary, please call for additional information. Dear Prospective Volunteer. Thank you for your interest in the volunteer program at Robert Wood Johnson University Hospital Rahway. We are happy to know that you are considering becoming a part of the

More information

South Plains College Respiratory Care 2017

South Plains College Respiratory Care 2017 South Plains College Respiratory Care 2017 Hello! We are pleased that you are interested in the South Plains College Respiratory Care Program. The Respiratory Care Program classes are offered exclusively

More information

VOLUNTEER APPLICATION

VOLUNTEER APPLICATION Please return to: Mount Nittany Medical Center Volunteer Services Department 1800 East Park Avenue State College, PA 16803 814.234.6170 VOLUNTEER APPLICATION Application Date Assignment Interview Date!

More information

PRE-REGISTRATION AND DEPARTMENTAL CLEARANCE IS REQUIRED EACH TIME YOU REGISTER FOR NUR 103 (NURSING ASSISTANT) OR NUR 104 (CNA2).

PRE-REGISTRATION AND DEPARTMENTAL CLEARANCE IS REQUIRED EACH TIME YOU REGISTER FOR NUR 103 (NURSING ASSISTANT) OR NUR 104 (CNA2). Central Oregon Community College Nursing Department 2600 NW College Way, Bend, Oregon 97703 Instructions for Department/Instructor Clearance and Registration PRE-REGISTRATION AND DEPARTMENTAL CLEARANCE

More information

Cherokee Nation W. W. Hastings Hospital Surgical Technology Program Application Booklet

Cherokee Nation W. W. Hastings Hospital Surgical Technology Program Application Booklet Cherokee Nation W. W. Hastings Hospital Surgical Technology Program Application Booklet Dear Prospective Student: Thank you for your interest in Cherokee Nation W. W. Hastings Hospital Surgical Technology

More information

Middle Tennessee State University School of Nursing Undergraduate Program Clinical Policy

Middle Tennessee State University School of Nursing Undergraduate Program Clinical Policy Middle Tennessee State University School of Nursing Undergraduate Program Clinical Policy The Middle Tennessee State University School of Nursing has one undergraduate degree seeking program. Tracks in

More information

State Center Community College District MADERA CENTER VOCATIONAL NURSING PROGRAM

State Center Community College District MADERA CENTER VOCATIONAL NURSING PROGRAM MADERA CENTER VOCATIONAL NURSING PROGRAM Applications are now being accepted. This information packet contains admission & application policies for ongoing admission to the vocational nursing program.

More information

Junior/Teen Volunteer Program

Junior/Teen Volunteer Program Junior/Teen Volunteer Program Dear Prospective Junior/Teen Volunteer: Enclosed you will find information and forms to complete to become a Junior/Teen Volunteer. The Junior/Teen Volunteer Program is a

More information

RN Refresher Program Information Packet

RN Refresher Program Information Packet MESA COMMUNITY COLLEGE RN Refresher Program Information Packet 2017-2018 Mesa Community College Nursing Department, Health & Wellness Building #8 (480) 461-7104 Fax (480) 461-7821 NONDISCRIMINATION POLICY

More information

STUDENT NAME: Date Completed:

STUDENT NAME: Date Completed: WINONA STATE UNIVERSITY College of Nursing and Health Sciences Graduate Programs in Nursing HEALTH INFORMATION AND REQUIREMENTS FOR PARTICIPATION IN THE GRADUATE PROGRAMS IN NURSING STUDENT NAME: Date

More information

ALLIED HEALTH INFORMATION PACKET

ALLIED HEALTH INFORMATION PACKET ALLIED HEALTH INFORMATION PACKET Allied Health Intent Form (please return) Nursing Requirements Point System/Course Check Offs Estimated Program Costs C.N.A. Application Contact Information Allied Health

More information

Deadline for application: April 1-29, Dear Summer Teen Applicant:

Deadline for application: April 1-29, Dear Summer Teen Applicant: Deadline for application: April 1-29, 2016 Dear Summer Teen Applicant: Thank you for your interest in the Summer VolunTeen Program at Methodist Healthcare. Positions are available at Methodist University,

More information

TEEN VOLUNTEER APPLICATION. Last Name, First Name, Middle Initial. Home Address ~ Number, Street, Apt. # City State Zip Code

TEEN VOLUNTEER APPLICATION. Last Name, First Name, Middle Initial. Home Address ~ Number, Street, Apt. # City State Zip Code Teen 14 ½ to 17 yrs. old Arrowhead Regional Medical Center 400 N. Pepper Avenue Colton, California 92324 (909) 580-6340 TEEN VOLUNTEER APPLICATION When completing this application, please Print Info. in

More information

BROOKLINE COLLEGE PHYSICAL THERAPIST ASSISTANT PROGRAM APPLICATION REQUIREMENTS

BROOKLINE COLLEGE PHYSICAL THERAPIST ASSISTANT PROGRAM APPLICATION REQUIREMENTS BROOKLINE COLLEGE PHYSICAL THERAPIST ASSISTANT PROGRAM APPLICATION REQUIREMENTS 2017-2018 Lynn E. Bagnull, PT, MBA Program Director lynn.bagnull@brooklinecollege.edu James Mulroy, PT, MS Academic Coordinator

More information

Woodbridge Nurse Aide Student Handbook

Woodbridge Nurse Aide Student Handbook 2018 Woodbridge Nurse Aide Student Handbook Nurse Aide Preparation (CNA) PRE ADMISSION REQUIREMENTS Students must have a US high school diploma OR GED OR proof of English 101 or 111 OR VPT English score,

More information

ALLIED HEALTH INFORMATION PACKET

ALLIED HEALTH INFORMATION PACKET ALLIED HEALTH INFORMATION PACKET Allied Health Intent Form (please return) Nursing Requirements Point System/Course Check Offs Estimated Program Costs C.N.A. Application Contact Information Allied Health

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

University of Evansville Physical Therapist Assistant Program Syllabus Office Hours Course Description Course Objectives 50% supervision

University of Evansville Physical Therapist Assistant Program Syllabus Office Hours Course Description Course Objectives 50% supervision University of Evansville Physical Therapist Assistant Program PT111: Clinical II (4 Credit Hours) Prerequisites: EXSS 112, EXSS 113, ID 356, PT 101, PT 102, PT 106, PT 200, and Required Clinical Health

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

Missouri Baptist University School of Nursing Bachelor of Science in Nursing (BSN) ADMISSION POLICY

Missouri Baptist University School of Nursing Bachelor of Science in Nursing (BSN) ADMISSION POLICY Missouri Baptist University School of Nursing Bachelor of Science in Nursing (BSN) ADMISSION POLICY 2017-2018 Students seeking the Bachelor of Science in nursing degree will apply to enter the program

More information

Applying to the Bachelor of Science in Athletic Training (BSAT)/ Athletic Training Program (ATP)

Applying to the Bachelor of Science in Athletic Training (BSAT)/ Athletic Training Program (ATP) Applying to the Bachelor of Science in Athletic Training (BSAT)/ Athletic Training Program (ATP) Instructions: Submit the following materials to 605B Bellmont Hall by 5:00pm on May 1 st :! A completed

More information

Cisco College Surgical Technology Program Application for Admission and Student Health Record

Cisco College Surgical Technology Program Application for Admission and Student Health Record Cisco College does not discriminate on the basis of race, color, creed, national origin, religion, age, gender, sexual orientation, political affiliation, or physical disability Applications to Health

More information

ATHLETIC TRAINING MANDATORIES INFORMATION

ATHLETIC TRAINING MANDATORIES INFORMATION ATHLETIC TRAINING MANDATORIES INFORMATION FIRST YEAR MANDATORIES (DUE DATE WILL BE ANNOUNCED IN CLASS) HIPAA/OSHA Training You will complete your training through the Evolve e-learning Solutions website.

More information

University of South Alabama College of Nursing Bachelor of Science in Nursing

University of South Alabama College of Nursing Bachelor of Science in Nursing ADMISSIONS POLICY Enrollment into the University (pre-professional component) as a nursing major does not assure the student admission to the Professional Component. Enrollment in the Professional Component

More information

ATHLETIC TRAINING MANDATORIES INFORMATION

ATHLETIC TRAINING MANDATORIES INFORMATION ATHLETIC TRAINING MANDATORIES INFORMATION FIRST YEAR MANDATORIES (DUE DATE WILL BE ANNOUNCED IN CLASS) HIPAA/OSHA Training You will complete your training through the Evolve e-learning Solutions website.

More information

POLICY TITLE: STUDENT CLINICAL REQUIREMENTS PART ONE

POLICY TITLE: STUDENT CLINICAL REQUIREMENTS PART ONE Page 1 of 6 STUDENT CLINICAL REQUIREMENTS PART ONE Policy Number: S101 POLICY TITLE: STUDENT CLINICAL REQUIREMENTS PART ONE The College of Nursing (CON) is committed to ensuring that all nursing students

More information

Southwest Mississippi Community College Practical Nursing Program

Southwest Mississippi Community College Practical Nursing Program Southwest Mississippi Community College Practical Nursing Program Applications submitted before June 15 th will receive priority Program Information and Application If you need to request this information

More information

Health Requirements for Students. Updated 1/23/18

Health Requirements for Students. Updated 1/23/18 Health Requirements for Students Updated 1/23/18 1 Health Requirements Table of Contents Health Requirements for Students... 3 Instructions on Getting Started... 4 Instructions on Uploading Documents...

More information

Paramedic Program Policies Book

Paramedic Program Policies Book Paramedic Program Policies Book Revised: 1/4/2016 Advisory Approval: 3/25/15 1 NCTC-EGF Paramedic A.A.S. Graduation Requirements: 1. Cumulative GPA of 2.0 2. All individual courses in the curriculum must

More information

Welcome to the Aims Community College Associate Degree Nursing Program Online Orientation for Fall 2018 Admission

Welcome to the Aims Community College Associate Degree Nursing Program Online Orientation for Fall 2018 Admission Welcome to the Aims Community College Associate Degree Nursing Program Online Orientation for Fall 2018 Admission Nursing Program State Approval and National Accreditation Information Colorado State Board

More information

DMACC INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD. Questions about uploading the form or CastleBranch?

DMACC INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD. Questions about uploading the form or CastleBranch? DMACC DES MOINES AREA COMMUNITY COLLEGE INSTRUCTIONS FOR COMPLETING STUDENT HEALTH AND IMMUNIZATION RECORD Health and Public Service Department students need to complete and submit the Student Health and

More information

IMPORTANT Instructions for Incoming First Semester ADN Students Spring 2018

IMPORTANT Instructions for Incoming First Semester ADN Students Spring 2018 IMPORTANT Instructions for Incoming First Semester ADN Students Spring 2018 Congratulations and welcome to first semester of the ADN Program! My name is Laura DeFreitas. I am course coordinator for first

More information

What you need to know. ADN / BSN Concurrent Enrollment Program (CEP) Revised 06/01/2016

What you need to know. ADN / BSN Concurrent Enrollment Program (CEP) Revised 06/01/2016 Working together to provide Associate and Baccalaureate Degrees in Nursing What you need to know ADN / BSN Concurrent Enrollment Program (CEP) Revised 06/01/2016 Revised 6/10/15 INTRODUCTION The Pima Community

More information

Middle Tennessee State University MSN Program. Clinical/Student Requirements- Admission to MSN Program

Middle Tennessee State University MSN Program. Clinical/Student Requirements- Admission to MSN Program Middle Tennessee State University MSN Program Clinical/Student Requirements- Admission to MSN Program The following are required documents that MUST be uploaded in Medatrax prior to beginning the MSN program.

More information

Physical & Occupational Therapy Services Clinical Education

Physical & Occupational Therapy Services Clinical Education Massachusetts General Hospital Physical and Occupational Therapy Services Policy & Procedure Manual Title: Physical & Occupational Therapy Services Policy: 600.014 Clinical Education Source: Physical &

More information

APP STUDENT CLINICALS APPLICATION

APP STUDENT CLINICALS APPLICATION APP STUDENT CLINICALS APPLICATION Thank you for your interest in performing clinicals at Stillwater Medical Center. Please read the following eligibility and requirements before completing the application.

More information

LONE STAR COLLEGE-TOMBALL DOCUMENTATION OF REQUIRED IMMUNIZATIONS Please Print

LONE STAR COLLEGE-TOMBALL DOCUMENTATION OF REQUIRED IMMUNIZATIONS Please Print LONE STAR COLLEGE-TOMBALL DOCUMENTATION OF REQUIRED IMMUNIZATIONS Please Print Name: (Last) (First) (MI) of Birth ID# Enrollment All students enrolled in health related courses who have or will have any

More information

Phlebotomy Certificate Program. Information Guidelines

Phlebotomy Certificate Program. Information Guidelines Phlebotomy Certificate Program Information Guidelines 2017-2018 Revised 8/2017 Arkansas Northeastern College Phlebotomy Certificate Program 2017-2018 The Certificate of Proficiency (CP) in Phlebotomy is

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

AND. Associates in Applied Science in Nursing and Bachelor s of Science in Nursing Concurrent Enrollment Program

AND. Associates in Applied Science in Nursing and Bachelor s of Science in Nursing Concurrent Enrollment Program AND Associates in Applied Science in Nursing and Bachelor s of Science in Nursing Concurrent Enrollment Program INTRODUCTION The Pima Community College (PCC)/Arizona State University (ASU) Concurrent Enrollment

More information

OBSERVER APPLICATION

OBSERVER APPLICATION OBSERVER APPLICATION Application Instructions: Please type all responses. Review and complete the application and required attachments following the application. A submission checklist is provided to ensure

More information

2013 Teen Volunteer Program

2013 Teen Volunteer Program 2013 Teen Volunteer Program Volunteer Services Office Dear Teen, Thank you for your interest in volunteering at. Students chosen to serve in our hospital will be those who can best represent our hospital

More information

University of Kansas Medical Center Department of Physical Therapy & Rehabilitation Science

University of Kansas Medical Center Department of Physical Therapy & Rehabilitation Science University of Kansas Medical Center Department of Physical Therapy & Rehabilitation Science PTRS 730: Integrated Clinical Experience II Course Coordinator: Jason Rucker, PT, PhD jrucker2@kumc.edu Semester:

More information

If you are currently a High School Senior. you will complete a general volunteer application, not this one.

If you are currently a High School Senior. you will complete a general volunteer application, not this one. 2018 North Cypress Medical Center Junior Volunteer Packet Must be a Current High School Sophomore or Junior If you are currently a High School Senior you will complete a general volunteer application,

More information

(907) PHONE (907) FAX

(907) PHONE (907) FAX 3260 Hospital Drive Juneau, AK 99801 Application for Medical, Nurse Practitioner, and Physician Assistant Students Bartlett Regional Hospital Medical Staff Services Office 3260 Hospital Drive Juneau, AK

More information

BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM GENERIC APPLICATION PACKET

BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM GENERIC APPLICATION PACKET BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM GENERIC APPLICATION PACKET Welcome Letter Application Requirements ATI TEAS Information TOEFL ibt Information Required Tests/Immunizations Contact Information

More information

Angelica Srivoraphan Business Development Coordinator Volunteer Services Leader Carolinas Rehabilitation Carolinas HealthCare System

Angelica Srivoraphan Business Development Coordinator Volunteer Services Leader Carolinas Rehabilitation Carolinas HealthCare System 2015 Dear Shadow Applicant: Thank you for your interest in the shadow program at Carolinas Rehabilitation. The shadow program will be a richly rewarding experience for you and I hope that you will find

More information

Welcome to the Aims Community College Associate Degree Nursing Program Online Orientation for Fall 2017 Admission

Welcome to the Aims Community College Associate Degree Nursing Program Online Orientation for Fall 2017 Admission Welcome to the Aims Community College Associate Degree Nursing Program Online Orientation for Fall 2017 Admission Nursing Program State Approval and National Accreditation Information Colorado State Board

More information

Student Pre-Clinical Requirements 2017

Student Pre-Clinical Requirements 2017 BACHELOR OF NURSING (COLLABORATIVE) PROGRAM Student Pre-Clinical Requirements 2017 Memorial University School of Nursing Centre for Nursing Studies Western Regional School of Nursing INTRODUCTION TO STUDENT

More information

APPLICATION FOR VOLUNTEER AMBASSADOR (18 yrs and older)

APPLICATION FOR VOLUNTEER AMBASSADOR (18 yrs and older) APPLICATION F VOLUNTEER AMBASSAD (18 yrs and older) Date Name Mailing Address City Zip Telephone Cell Phone E-mail Address EMERGENCY CONTACT EDUCATION: High School College Other Schools/Training REFERENCES:

More information

Nurse Aide. We reserve the right to cancel any class due to insufficient enrollment.

Nurse Aide. We reserve the right to cancel any class due to insufficient enrollment. Nurse Aide We reserve the right to cancel any class due to insufficient enrollment. **All clinical dates may vary according to site and instructor availability ABOUT THE NURSE AIDE PROGRAM The Nurse Aide

More information

NORTHEAST TEXAS COMMUNITY COLLEGE Professional Education and Allied Health

NORTHEAST TEXAS COMMUNITY COLLEGE Professional Education and Allied Health Phlebotomy Program APPLICATION INFORMATION The Phlebotomy Program at Northeast Texas Community College is a course series designed to prepare students to take the national certification test with the American

More information

RUTGERS SCHOOL OF NURSING - CAMDEN STUDENT HEALTH RECORDS PACKET

RUTGERS SCHOOL OF NURSING - CAMDEN STUDENT HEALTH RECORDS PACKET School of Nursing-Camden Rutgers, The State University of New Jersey Residence Hall 215 North 3 rd Street Camden, NJ 08102-1405 nursing.camden.rutgers.edu nursecam@camden.rutgers.edu Phone: 856-225-6226

More information

Dear Volunteen Applicant:

Dear Volunteen Applicant: Dear Volunteen Applicant: Thank you for your interest in volunteering at Marian Regional Medical Center. Our Volunteen Program is for current high school students who are at least 14 years old. Please

More information

HONORHEALTH Military Partnership

HONORHEALTH Military Partnership Annual Tour (AT) Requirements & Prerequisites Checklist (As Of March 2017) HONORHEALTH Military Partnership Scottsdale Osborn Medical Center 7301 E 4 th Street, Suite 1 Lenore Portante Military Partnership

More information

Admissions Packet

Admissions Packet 2018-2019 Admissions Packet Dear Prospective Nursing Student, Congratulations on your decision to pursue the Practical Nursing Program at Washburn Tech. This packet will help guide you through the application

More information

Critical Requirements Packet 2016 Grad p 2

Critical Requirements Packet 2016 Grad p 2 C R I T I C A L R E Q U I R E M E T S Please Read and Retain This Letter As Well As All Documentation for our Records All students admitted to the College of ursing are required to provide documentation

More information

Middle Tennessee State University MSN Program. Clinical/Student Requirements- Admission to MSN Program

Middle Tennessee State University MSN Program. Clinical/Student Requirements- Admission to MSN Program Middle Tennessee State University MSN Program Clinical/Student Requirements- Admission to MSN Program The following are required documents that MUST be uploaded in Medatrax prior to beginning the MSN program.

More information

BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN-TRANSITION APPLICATION PACKET

BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN-TRANSITION APPLICATION PACKET BLINN COLLEGE ASSOCIATE DEGREE NURSING PROGRAM LVN-TRANSITION APPLICATION PACKET Welcome Letter Application Information for LVN-Transition Application Requirements ATI TEAS Information TOEFL ibt Information

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

BACKGROUND CHECKS. Therefore, as a condition of admission each student MUST COMPLETE the background check process before beginning any coursework.

BACKGROUND CHECKS. Therefore, as a condition of admission each student MUST COMPLETE the background check process before beginning any coursework. ccc FLORIDA ATLANTIC UNIVERSITY BACKGROUND CHECKS State legislation requires a full background check for all individuals in process of admission to the Christine E. Lynn College of Nursing. Partnering

More information

EMT-BASIC STUDENT POLICY MANUAL COURSE GUIDE

EMT-BASIC STUDENT POLICY MANUAL COURSE GUIDE EMT-BASIC STUDENT POLICY MANUAL & COURSE GUIDE 2017-2018 TABLE OF CONTENTS: Program Description................................................ 3 Goal Statement....................................................

More information