Baton Rouge Community College Medical Assistant Certificate of Technical Studies MEDICAL ASSISTANT ADMISSION PACKET BEFORE COMPLETING THIS PACKET 1. Complete and Submit MEDICAL ASSISTANT PROGRAM APPLICATION (ONLINE) https://goo.gl/forms/yxyi6xujacpwztjm2 2. Contact Nursing and Allied Health Academic Advisor Christin Dillon at 225-216-8879 or dillonc@mybrcc.edu or Medical Assistant Program Manager Paulette Pourciau at 225-359-9437 or pourciaup@mybrcc.edu 3. Complete MEDICAL ASSISTANT PROGRAM ADMISSION PACKET After Completion of 1 and 2 Above. All documents must be submitted to the Medical Assistant Program Manager, Paulette Pourciau, or program instructor at the location you chose to attend, one week before classes begin (NO EXCEPTIONS). Please keep a copy of everything you submit. It is the policy of Baton Rouge Community College not to discriminate on the basis of age, sex, race, color, religion, national origin or disability in its educational programs, activities or employment policies. 1
STEPS 1 2 3 ACADEMIC REQUIREMENTS Students must be 18 years or older, and have a high school diploma from a regionally accredited institution or a General Educational Development (GED)/ HISET diploma. Students must complete the Baton Rouge Community College online application process and be fully admitted to the college. You will be issued a student ID number which is required for step 4. Students must have achieved the following test scores: ACCUPLACER ACT COMPASS Placement Math 20-45 (Elem. Alg.) 1-14 0-46 (COPA) MATH 0097 English 20-59 (Sent. Skills) 12-13 21-37 (COEN) ENGL 0090 Reading 20-52 (Read. Comp.) 12-13 21-50 (CORE) READ 0090 COMPASS and Accuplacer scores must be no older than 3 years and ACT scores must be no older than 5 years at time of admission to the program. Study resources are available on the Testing Center s website. http://www.mybrcc.edu/academics/division_innovative_learning/testingcenter/forms.php Students are strongly encouraged to prepare before taking the placement exam. If a student does not achieve the appropriate test scores, the student can either retest or complete the developmental course sequence 4 5 Complete and submit the Medical Assistant Program Application ONLINE. After you have submitted the Medical Assistant Program Application, you will be contacted by program personnel with additional admission requirements. If you have questions or need assistance contact the Nursing and Allied Health Academic Advisor Christin Dillon at 225-216-8879 or the Medical Assistant Program Manager Paulette Pourciau at 225-359-9437. PROGRAM AND LOCATION CONTACTS Acadian Site, Program Manager Paulette Pourciau (225-359-9437) pourciaup@mybrcc.edu 3250 N. Acadian Thruway E. Baton Rouge, LA 70805 Jackson Site, Program Instructor Brenda Williams (225-634-2636) williamsb2@mybrcc.edu 3337 Highway 10 Jackson, LA 70748 New Roads, Program Instructor Debra Bailey (225-638-8613) baileyd@mybrcc.edu 605 Hospital Road New Roads, LA 70760 2
MEDICAL ASSISTANT, CERTIFICATE OF TECHNICAL STUDIES (CTS) COURSES BY SEMESTER Course Number Course Title Credit Hours Clock Hours First Semester MAST 1171 Medical Terminology for Medical Assistants 1 15 MAST 1152 Human Body for Medical Assistants 2 60 MAST 1162 Professionalism in Healthcare 2 60 MAST 1142 Pharmacology for Medical Assistants 2 60 MAST 1014* Phlebotomy 4 120 MAST 1221 Clinical Procedures I 1 90 12 405 Second Semester MAST 1214 Administrative Procedures 4 120 MAST 2132 Clinical Procedures II 2 105 MAST 1114* Electrocardiography (EKG) 4 90 MAST 2222 Medical Assistant Externship 2 180 12 495 Total Curriculum Hours 24 900 *MAST 1014, Phlebotomy, and MAST 1114, Electrocardiography (EKG), may be offered in a different semester other than the one listed, depending on the availability of BRCC/clinical sites. 3
CLINICAL REQUIREMENTS Instructions 1. CPR: You must have a current American Heart Association BLS Provider Cardiopulmonary Resuscitation (CPR) card. *CPR card must be valid for the duration of the program. 2. Criminal Background Check: You must complete a criminal background check from the Louisiana State Police Department. 3. Health Requirements: The following are required by the agencies we use for clinical rotations. All requirements should be dated within the last year unless otherwise indicated. Immunization: Tetanus vaccine (current 10 years) Hepatitis B Series or a titer (current 10 years) Lab: Complete Blood Count HIV test (current 5 years) VDRL/RPR Varicella Titer MMR Titer Hepatitis B Series or a titer (current 10 years) TB skin test or Chest X-ray 4. Health History and Physical Examination Forms: Have your primary care provider complete the health and physical forms; if you do not have a health care provider a list of local resources is attached. The providers address and contact information must be written/stamped on the bottom of the health history form. 5. Drug Screening: Students are required to complete a 10 panel urine drug screening. Items Due Current American Heart Association Healthcare Provider CPR Card Online courses are not accepted for initial certifications Results must be submitted to program manager or course instructor. Submit copies of immunization and lab records to the program manager or course instructor Completed health and physical forms. ***Completed form must include healthcare provider address and contact information otherwise forms will not be accepted**** Complete the release form. 6. Registration: All documentation must be submitted to the program manager or course instructor before you can register for your classes. 4
HEALTH HISTORY AND PHYSICAL EXAMINATION HEALTH HISTORY Last Name First Name Middle Name Banner # Date of Birth (Month / Day / Year) Gender M Male F Female Racial / Ethnic Group A Asian A.I. American Indian B Black H Hispanic/Latino P.I. Pacific Islander W White O Other Mailing Address City / State Zip Code Home Phone Number ( ) Emergency Contact (Name / Relationship) Cell Phone Number ( ) E-Mail Address Emergency Contact Number ( ) Have you ever been treated, or are you receiving treatment for any of the following conditions -mark all that apply and comment below. YES* NO Condition YES* NO Condition YES* NO Condition Alcohol/Substance Abuse Diabetes Orthopedic Disorder Allergies: Food Eating Disorder Seizure Disorder Allergies: Medication Emotional Disorder Social Disorder Asthma Heart Disorder Trauma Back Injury / Disorder Hearing Disorder Tuberculosis Blood Disorder Intestinal Disease Vision Disorder Cancer Kidney Disease Pregnancy *Provide dates and an explanation for yes responses in the space provided below. * Please use additional paper if needed to fully explain your yes answers. Explanations / Other: List Surgical History: List Routine Medications: All pre-existing medical conditions require a medical release from your health care provider. Attached? Yes N/A 5
PHYSICAL EXAMINATION Last Name: First Name: Middle Initial: System NORMAL ABNORMAL COMMENTS General Health Cardiovascular Endocrine Extremities HEENT Gastrointestinal Neurologic Respiratory Reproductive Skeletal Skin Urinary B/P Pulse Resp Temp Weight Height MMR Titer* IMMUNIZATION DOCUMENTATION Please attach copies of immunization records and lab results* REQUIRED IMMUNIZATION / LABS DATE RESULTS / COMMENTS Hepatitis B Vaccine Series* Dates of vaccination #1 #2 #3 Or Date and result of Hepatitis B Vaccine Titer* TB Skin Test* If (+) TB skin test treatment received? If (+) TB attach copy of most recent Chest x-ray Varicella Titer* HIV* dated within last in last 5 years. CBC* VDRL / RPR* Tetanus Vaccine dated within last 10 years Does the student have any physical, medical or mental conditions that would impede their ability to provide safe and competent care of patients in a health care environment? No Yes (please comment below) Examining Health Care Provider: Health Care Provider Comments: Date: Health Care Provider office / address contact information: 6
Ten Panel Urine Drug Screen Dear Lab Personnel, I am requesting a urine drug screen for the purpose of student enrollment in the Medical Assistant Program at Baton Rouge Community College I give consent for the facility to release my lab results to Paulette Pourciau, Medical Assistant Program Manager. Thank you, Student Name (Print) Student Name (Signature) Date PROGRAM CONTACT Paulette Pourciau, Medical Assistant Program Manager 225-359-9437 (office) pourciaup@mybrcc.edu 225-216-8326 (fax) Christin Dillon, Nursing and Allied Health Division Advisor 225-216-8879 (office) dillonc@mybrcc.edu 225-216-8115 (fax) 7
SERVICE PROVIDERS Criminal Background Check: Must be completed at Louisiana State Police Headquarters 7919 Independence Blvd, Baton Rouge, LA 70806 (225.925.6006) CPR SERVICES: AHA Healthcare Provider CPR cards issued by your employer will be accepted. You may use any AHA Health Care Provider. The following are community providers: Operation Life Saver Training Center CPR Services Stephanie Smith 225.753.7716 *CPR card must be valid for the duration of the program. OLOL Health Career Institute 225. 214.6964 http://69.2.57.119/aha.html Partners in Healthcare Education- CPR Robin Parker 225.389.0067 HEALTH SERVICES: All health requirements can be completed by you primary care practitioner (PCP). The tests required are expensive, we have negotiated discount service rates with the providers listed below. To obtain the contracted rates inform them you are a BRCC MEDICAL ASSISTANT STUDENT. Health History and Physical: BRG Family Health Center (appointments only low rates) (225-381-6620) 3801 North Blvd, BR, La, 70806 Capitol City Family Health Center (Income based fee scale) (225.650.2000) 3140 Florida Street, Baton Rouge, LA 70806 Total Occupational Medicine (225.924.4460 ) 333 Drusilla Lane, Baton Rouge, LA 70809 LABS and IMMUNIZATIONS: BRG Family Health Center (appointments only low rates) (225-381-6620) 3801 North Blvd, BR, La, 70806 Capitol City Family Health Center (Income based fee scale) (225.650.2000) 3140 Florida Street, Baton Rouge, LA 70806 Total Occupational Medicine (225.924.4460 ) 333 Drusilla Lane, Baton Rouge, LA 70809 EBRP Health Unit (225.242.4860) 353 North 12 th Street, Baton Rouge, LA 70802 *** Only provides tetanus vaccine and HIV test (HIV test is only provided at 8am or 1pm)*** Work Force Medical (walk ins welcome low rates) (225.926.6687) 604 Chevelle Ct, # A, Baton Rouge, LA 7080 *** Hep. B and tetanus vaccines are not provided*** 8
STUDENT ACKNOWLEDGEMENT FORM Student must read and initial in the space next to each item listed below: 1. I have read and fully understand the curriculum plan for the program. 2. I promise to put in the effort required to be successful in the program. 3. I understand that if I do not take the full load of courses offered each semester it will take me longer to complete the program. 4. I understand that if I do not successfully complete all the courses for which I am registered in a given semester, I will have to retake those courses before I can continue the program. This may mean waiting more than one semester until the courses I need to repeat are offered again. 5. If I am in the final semester of the program, I will not be allowed to graduate until I have successfully completed all required course work. This includes any required Clinical Externship hours that I have missed. 6. If I am removed from a clinical site because of inappropriate behavior, I will be terminated from the program. I, have read and understood all of the 6 items listed above. (Printed name of student) (Student signature) Date (Course Instructor signature) Date A completed copy of this form must be placed in the student academic record folder. 9
ESTIMATED PROGRAM S Medical Assistant Certificate of Technical Studies 2 semesters (Fall, Spring) Total credit hours 24 Tuition Tuition $134.89 per credit hour $3,237.36 Fees Fees $41 per credit hour 984.00 Cap and Gown 32.00 Total Tuition and Fees $4,253.36 Admission Requirements Health Assessment and titers (estimated without insurance) 200.00 State Background Check 36.00 CPR 40.00 MMR/Hep B/Varicella titer 50.00 TB skin test 15.00 Urine Drug test 10 panel 40.00 Total Admission Requirements $381.00 Textbooks "Essentials of Medical Assisting", 2nd Ed Diane Klieger ISBN 9781416056744 Textbook "Essentials of Medical Assisting", 2nd Ed Diane Klieger ISBN 9781416056751 Workbook "Electrocardiography for Healthcare Professionals", 4th Ed Kathryn Booth Thomas Obrien ISBN 9780078020674 "Phlebotomy Essentials", 6th Ed Ruth McCall/Cathee, M. Tanskersley ISBN 9781451194524 60.00 45.00 100.00 Total Textbooks $280.00 NHA Certification Preparation Materials 65.00 75.00 Uniforms 2 Uniforms (Ceil Blue) ( Approximately $20.00-$30.00 each) 60.00 White Shoes 50.00 TOTAL UNIFORMS $110.00 Supplies/Tools Notebooks, Pens, Pencils, Highlighters 20.00 Watch with a second hand 25.00 Stethoscope and Blood Pressure 40.00 TOTAL SUPPLIES/TOOLS $85.00 Total Cost (subject to change) $5,174.36 10