Health Sciences Program Application Associate in Science Degree in Radiography For admission consideration, you must submit this application with any required documentation and have all of your grades posted to your Valencia transcript by the application deadline. Please fill in all blanks. Date of Application: Applying for (Term and Year): VID# (Required) Name (Last) (First) (Middle) Home Address City, State, Zip Primary Phone Number: Secondary Phone Number: Atlas E-mail: @mail.valenciacollege.edu (Admission decisions will be sent to your Atlas email 6-8 weeks after the application deadline) Are you a U.S. Citizen, a U.S. permanent resident, or hold a non-immigrant visa with employment authorization? Yes No (Non-immigrant status students can visit the U.S. Department of State directory of visa categories to verify employment eligibility https://travel.state.gov/content/visas/en/visit/visitor.html) Are you an International Student? Yes No INTERNATIONAL STUDENTS ONLY: Have you contacted the Health Sciences Compliance Office? Yes No NOTE: International Students must complete their background check, fingerprinting, drug testing, immunizations and CPR certification at least six months in advance of the anticipated start term. You cannot submit an application until you have contacted the Health Sciences Compliance Office to begin the compliance process and background check. Health Sciences Compliance department can be reached at: HSCompliance@valenciacollege.edu Education History If you have applied to other limited access Health Sciences programs at Valencia in the past 12 months, indicate which ones: Have you previously been accepted into a Health Sciences Program at Valencia College and subsequently deemed ineligible for return to the program? Yes No (NOTE: The selection committee has the right to contact the applicant s previous program; this information will be included in the consideration for program admission.) Please list all colleges/universities/postsecondary institutions you have attended: 1
Education History (cont.) If you have attended other institutions outside of Valencia, have all of your official transcripts from these institutions been submitted to Valencia and posted to your Valencia record? This includes your High School transcript or GED score card. (Check unofficial transcript in Atlas.) Yes No (Your application will be ineligible if you are missing transcripts.) Have you previously attended a Radiography program? If so, please list names(s) of institution(s) and dates attended: Are you a Career Pathways or NAF (AOHS) Graduate from high school? Yes No (Attach documentation.) Were you selected as an Alternate for Valencia s Radiography Program from the previous year? Yes No Certification Do you hold a current certification or registry in Radiation Therapy RT (T), Sonography (RDMS), Nuclear Medical Tech (NMT) or Cardiovascular Tech (CVT) and Cardiovascular Tech (RCIS)? No Yes, and I have attached the appropriate documentation indicating certification and/or registry in the following specialties: Do you hold current certification(s) in Nurse (RN), Medical Lab Tech (MLT), Medical Tech (MT) or Respiratory Care Tech (RRT)? No Yes, and I have attached the appropriate documentation indicating certification and/or registry in the following specialties: Academics All official transcripts must be submitted to Valencia and evaluated by the application deadline, including any AP/IB/CLEP official score reports (must be requested from collegeboard.org for AP/CLEP or ibo.org for IB). Check unofficial academic transcript (Login to Atlas Courses tab, Registration, Transcripts) to verify that transcripts have been received and evaluated by Valencia. Your application will be ineligible if you are missing any transcripts. What is your overall college GPA, including all transfer work? Please enter your ATI TEAS composite score as it appears in your Atlas account. To view your ATI TEAS score in Atlas: Login to Atlas, Go to Courses, Registration, Transcripts, View Test Scores If your ATI TEAS score does not appear in your Atlas account, please contact the Assessment Center at: Assessment@valenciacollege.edu 2
COURSE CHART INSTRUCTIONS: Enter grades for courses completed with a minimum grade of C (for Humanities, highest grade should be entered). If you took science courses that have separate grades for the lecture and the lab, enter both grades. Enter AP/IB/CLEP as the grade, if applicable. You must submit official scores and we cannot accept scores from other school transcripts. Enter R as the grade if you are currently registered in a course. If you have not taken a course, please enter No or leave blank. Any blank spaces will be assumed to be courses not taken; therefore, please fill out chart carefully and completely. If you are unsure about a course, enter it just in case and it will be reviewed. Course Chart Valencia Course prefix/ number Course prefix/ Required Number Credits (if different) Course Title Grade Name of Institution Attended Term/ Year Taken (e.g. Fall2014) BSC209C 4 *Human Anatomy & Physiology I BSC2094C 4 *Human Anatomy & Physiology II MAC1105 *College Algebra HSC151 *Medical Terminology ENC1101 Freshman Composition I CGS1060 OR CGS2100 PSY2012 or PSY1012 *Introduction to Computers OR Computer Fundamentals and Applications General Psychology Any course that meets Gen. Ed. Humanities req. (highest grade) PHY1007C 4 Physics and Medical Applications (or higher-level Physics course) HSC1004 or SLS1122 Professions of Caring Or New Student Experience PHI2600 Ethics and Critical Thinking * Indicates courses required to be completed by the application deadline
Radiography Core Performance Standards for Admission and Progression ISSUE STANDARD EXAMPLES OF REQUIRED ACTIVITIES (NOT ALL INCLUSIVE) Critical Thinking Interpersonal Communication Mobility Motor Skills Hearing Visual Tactile Critical Thinking ability sufficient for safe clinical judgment. Interpersonal abilities sufficient to interact with individuals, families, and groups from a variety of social, emotional, cultural, and intellectual backgrounds. Communication abilities sufficient for interaction with others in verbal and written form. Physical abilities sufficient to move from room to room and maneuver in small spaces. Gross and fine motor abilities sufficient to provide safe and effective care. Auditory abilities sufficient to monitor and assess patient needs, and to provide a safe environment. Visual ability sufficient for observation and assessment necessary in the operation of equipment and care of patients. Tactile ability sufficient for patient assessment and operation of equipment. * Identify cause-effect relationships in clinical situations. * Evaluate radiographs to ascertain that they contain proper identification and are of diagnostic value. * Select exposure factors and accessory devices for all radiographic procedures with consideration of patient size, age, and extent of disease. * Assess patient s condition and needs from a distance of at least 20 feet. * Initiate proper emergency care protocols, including CPR, based on assessment data. * Establish rapport with patients, families, and colleagues. * Display compassion, empathy and concern for others * Demonstrate a high degree of patience. * Work with other healthcare providers in stressful situations * Communicate in English to the patient in order to: converse, instruct the patient, relieve anxiety, gain their cooperation during procedures, understand the patient when communicating symptoms of a medical emergency. * Read the patient s medical chart and/or physician s orders. * Legibly write patient history. * Documents own actions and patient responses as indicated. * Assist all patients, according to individual needs and abilities, in moving, turning, transferring from transportation devices to the x-ray table, etc. * Be able to push, pull, and lift 40 pounds. * Push a stretcher, wheelchair or other transportation device without injury to self, patient, or others. * Push a portable x-ray machine from one location to another, including turning corners, getting on and off of an elevator, and manipulating it in a patient s room. * Manually move the x-ray tube and position the tube at various angles at heights up to 7 feet. * Accurately draw up sterile contrast media and other solutions without contaminating the syringe and/or needle, etc. * Place cassettes in Bucky trays and spot film devices and properly manipulate all locks. * Physically be able to administer emergency care including performing CPR. * Be able to stand for periods as long as 2 hours wearing lead aprons and to walk a distance of 2 miles during a normal work day. * Input data into computer * Hear a patient talk in a normal tone from a distance of 20 feet. * Hear monitor alarm, emergency signals, and cries for help. * Observe the patient in order to assess the patient s condition and/or needs from a distance of, at least, 20 feet. * Can see numbers, letters, calibrations, etc. of varying sizes located on equipment utilized by a radiographer. * Perform palpation, tactile assessment, and manipulation of body parts to insure proper body placement and alignment. * Manipulate dials, buttons, and switches. 4
Radiography Core Performance Standards for Admission and Progression (Continued) Radiography is a practice discipline with cognitive, sensory, affective, and psychomotor performance requirements. Based on these requirements, the above list of "Core Performance Standards" has been developed. Each standard has an example of an activity or activities, which a student will be required to perform while enrolled in the Radiography Program. These standards are a part of each Radiography course and of the professional role expectation of a Radiographer. For the purpose of the Radiography Program, a qualified individual with a disability is one who, with or without reasonable accommodations or modifications, meets the essential eligibility requirements for participation in the program." The School of Allied Health at Valencia makes no preadmission inquiries concerning an applicant s disability status. Information related to an applicant s disabilities is not a part of the information reviewed by the Admission Committee. These Performance Standards should be used to assist students in determining whether accommodations or modifications are necessary for the student to meet program requirements. A student who identifies potential difficulties with meeting the Performance Standards should communicate his/her concerns to an advisor in the Office for Students with Disabilities. The student has the responsibility to identify and document the disability and to request reasonable and appropriate adjustments. Determination is made on an individual basis as to whether any accommodations or modifications can be reasonably made. I have read and understand the performance standards necessary to be a competent Radiographer. Signature Print 5
For admission consideration, you must submit this application with any required documentation and have all of your grades posted to your Valencia transcript by the Radiography Program application deadline. DECLARATION I have reviewed all admission requirements and expectations in the Valencia Radiography Program Guide. I understand that it is fraudulent to misrepresent any information on this application and I affirm that all information on this application is true. I understand that, if admitted to this program, I must submit to a criminal background check, fingerprinting, and drug screening, document immunizations and other requirements for clinical participation, and be free of offenses that would disqualify me from the program. I have read and understand the performance standards necessary to be a competent Radiographer. Signature Date HOW TO SUBMIT APPLICATION: A non-refundable Health Sciences Program Application fee of $15 must be submitted to the Business Office http://valenciacollege.edu/businessoffice with each application. By mail: Please mail the application together with a check or money order payable to Valencia College to the address listed below. Do not send separately. Valencia College Business Office 4-6 PO Box 491 Orlando, FL 2802 In-person: Please make payment by credit card, debit card, cash, check, or money order (a check or money order must be payable to Valencia College) to the Business Office on the East, West or Osceola campuses only. The Business Office locations are as follow: West Campus: SSB, Rm 101 East Campus: Bldg. 5, Rm 214 Osceola Campus: Bldg. 2, Rm 110 NOTE: A representative from the Business Office will forward your application to the College Admissions office for screening and processing. Admission Decisions All admission decisions will be sent to your Valencia ATLAS email account approximately 6 to 8 weeks after the application deadline. If you are accepted you must confirm your seat via email by the requested deadline, or you will jeopardize your acceptance. Admission decisions will NOT be sent via postal mail. Revised 11/2/2018 6