Associate of Science in Radiologic Science APPLICATION Deadline for 2018 Cohort: March 15, 2018 Instructions 1. Complete a College of Coastal Georgia Application and complete all college admission requirements. 2. Complete a Radiologic Science Program Application. 3. Complete the HESI A2 test by March 15th. Request copy of HESI A2 to be submitted to the School of Nursing & Health Sciences if test taken other than CCGA from http://evolve.elsevier. com 4. Pay attention to due dates. The deadline for submission and/or postmark of the Radiologic Science Application AND all Official documentation and/or transcripts from other institutions is March 15 th. All interested students must submit a new application each year. 5. With application, submit signed Health Insurance Requirement Form and Performance Standards (Core Essentials) Form. 6. Letters of program status (acceptance or denial) will be mailed to all candidates in April. Please do not call our offices in regard to individual status as officials do not discuss this matter over the phone prior to the sending of letters. 7. Attend the first CCGA orientation session offered after you are accepted to CCGA. Please do this to ensure that you have all the pertinent information about college policies and to ensure timely registration for the classes you desire. Radiologic Science Program Specifics 1. The Radiologic Science class accepts new students each Spring.. 2. The deadline for applying to the program for the Fall is March 15th. 3. A Radiologic Science major may begin core curriculum classes any semester desired. 4. The core classes required for Radiologic Science: English 1101 with a grade of C or better Humanities Elective (Area C Elective) Math 1001 or Math 1111(if both classes are completed, the most recent grade will be used for program admission ranking) with a grade of C or better Biology 2110 and Biology 2111 (or equivalent) with a grade of C or better in each course Psychology 1101 History 2111 or History 2112 Political Science 1101 Students are encouraged to complete ALL core prior to beginning the Radiologic Science courses. 5. Students must have a minimum overall GPA of 2.5. The overall GPA includes all unadjusted transfer and unadjusted institutional grades. Page 1 of 5
Associate of Science in Radiologic Science APPLICATION Deadline for 2018 Cohort: March 15, 2018 DATE: CCGA Student ID#: Full Name: last middle first Date of Birth: Email Address: Telephone: Home/Cell The above information will be used for communicating with you. Please report any changes immediately to the School of Nursing and Health Sciences (912) 279-5860 or (912) 279-5870. Be sure the Registrar s office also receives these changes. Have you ever attended a radiologic science program? Yes No If yes, where: Date attended: Do you hold or have you ever held any Health related license or certification? Yes No License/Certificate Number: Do you hold a degree? Circle all that apply: Associate Baccalureate Master Page 2 of 5
American Registry of Radiologic Technologists (ARRT) Ethics Requirements: https://www.arrt.org/students-of-the-profession/requirements/ethics Individuals who have been involved in a criminal proceeding or who have been charged with or convicted of a crime must file a request for an Ethics Pre-Application Review with the American Registry of Radiologic Technology (ARRT), the credentialing agency for radiologic technologists. All offenses must be reported regardless of how long ago they were committed. The Ethics Pre-Application Review and the appropriate non-refundable fee are to be submitted to the ARRT. This is the student/applicant s sole responsibility. The ARRT Ethics Committee will contact the student in regard to the Pre-Application Review decision. A copy of the final decision from the ARRT must be presented to program officials no later than the first day of enrollment in the Radiologic Science Program. STUDENTS WHO DO NOT POSSESS A FINAL ARRT PRE-APPLICATION REVIEW DECISION ON THE FIRST DAY OF ENROLLMENT IN THE RADIOLOGIC SCIENCE PROGRAM WILL BE IMMEDIATELY DISMISSED FROM THE PROGRAM. Students are advised that the ARRT Pre-Application Review process can take up to 12 weeks to be completed. Criminal background checks and/or drug testing may be required by individual clinical sites. The cost will be the responsibility of the student. Denial to a clinical site as a result of the check/testing could result in dismissal from the program. Have you ever had a charge or conviction, a plea of guilty, or a plea of nolo contendere (no contest) to an offense that is classified as a misdemeanor or felony? (This includes a situation in which the result is deferred or withheld adjudication, suspended or stay of sentence, or where the individual enters into a pre-trail diversion activity. Military court-martials are also included.) Yes No (please circle one) I certify that the above answers are correct to the best of my knowledge. My signature is verification that I have read, understand, and agree to abide by all rules and regulations as stated in the application. I understand that if I have been charged or convicted of a crime I could be ineligible for the ARRT Registry Examination even if I successfully complete the CCGA Radiologic Science Program. I further attest to my willingness to accept any consequence that can occur as a result of my deliberate misrepresentation or withholding of information. Student s Printed Name Student s Signature Date Date Return to: Radiologic Science Program Director College of Coastal Georgia 1 College Drive Brunswick, GA 31520-3644 FOR OFFICE USE ONLY: Date Application Received: Page 3 of 5
COLLEGE OF COASTAL GEORGIA Performance Standards for Admission and Progression* All students applying to the Radiologic Science Program are expected to have the following competencies in order to effectively and safely perform the responsibilities of a radiologic science student. Requirements Standards Examples Critical Thinking Critical-thinking ability sufficient Identification of cause/effect relationships in clinical for rapid clinical judgment and situations Use of the scientific method in the development of decision making. patient care plans Evaluation of the effectiveness of patient care interventions. Interpersonal Communication in English Mobility Motor skills Hearing Visual Tactile Sense Interpersonal abilities sufficient for interaction with individuals, families and groups, from various social, emotional, cultural and intellectual backgrounds. Communications abilities sufficient for verbal and written interaction with others to include note taking abilities and the ability to rapidly interpret and disseminate information. Physical abilities sufficient for movement from room to room in small spaces Gross and fine motor abilities sufficient for providing safe, effective patient care Auditory ability sufficient for monitoring and assessing health needs Visual ability sufficient for observation and assessment necessary while patient is in your care Tactile ability sufficient for physical assessment and for radiographic positioning. Establishment of rapport with patients/clients and colleagues capacity to engage in successful conflict resolution Peer accountability Explanation of diagnostic/ treatment procedures Documentation and interpretation of patient care actions and patient/client responses Capable of both verbal and non-verbal communication. Movement about radiographic room, work spaces and patient room as necessary. Ability to stand for up to three hours without rest. Administration of rescue procedures-cardiopulmonary resuscitation (CPR) Ability to withdraw contrast media from a vial according to guidelines. Ability to perform venipuncture as necessary. Ability to handle clinical specimens and biohazardous materials according to guidelines. Calibration and use of equipment Therapeutic positioning of patients Ability to operate radiographic equipment according to departmental regulations Ability to lift without assistance up to 25lbs. Ability to hear monitoring device alarm and other emergency signals Ability to discern auscultatory sounds and cries for help Ability to observe patient's condition and responses to examinations and/administration to contrast media. Ability to visualize images on a computer monitor and/or radiographic film. Ability to palpitate in physical examinations and/or radiographic positioning. * There may be more stringent requirements for clinical agencies that may preclude the student s progression in the Radiologic Science Program. I have read the above Performance Standards for Admission and Progression and hereby represent that I can effectively and safely perform the competencies listed. Signed: Date: Page 4 of 5
COLLEGE OF COASTAL GEORGIA Notification of Health Insurance Requirements for Student Practice at Certain Clinical Sites While the College of Coastal Georgia encourages that all students have health insurance coverage to promote optimal health and wellness outcomes, the College does not require students to have health insurance as a condition of enrollment. However, students who are pursuing a degree in a health science or related clinical or pre-medical field may be required by certain clinical practice sites to have health insurance. You are receiving this notification and acknowledgement of responsibility because you are a student enrolled in a course of study that may require you to train at a clinical practice site which requires health insurance coverage of its employees and student trainees. Acknowledgment of Responsibility As a student at the College of Coastal Georgia, I understand that I am enrolled in a course of study that will require my participation in one or more clinical training programs at a hospital or health care facility. I have been advised that while working in such an environment every effort will be made to protect me, however, it is possible that I may be involved in an accidental injury or be exposed to illnesses and diseases that might require medical treatment. For this reason, many hospitals and health care facilities providing clinical rotation opportunities require students to have comprehensive sickness and accident health insurance coverage equivalent to that carried by their employees. These institutions may request me to provide proof of my healthcare coverage. I understand that if I do not maintain healthcare coverage while enrolled in a course with a clinical component, or if I am unable to provide proof of coverage, I could be removed from the clinical rotation, which would result in my being removed from the program and failing the course. I also understand that health insurance coverage is important, because if I am injured or become ill as a result of my clinical rotation, any costs for medical treatment will be my sole responsibility. I have read and understand the college health insurance advisory above. My signature is proof of my commitment to obtain and maintain health insurance coverage should the college or a clinical site require it. Signed: Date: *Students who need access to health insurance coverage should consult the student handbook and/or request information from the School of Nursing and Health Sciences or the Office of Student Affairs. Group health insurance is available for individual, voluntary purchases through a number of student professional associations as well as the University System of Georgia. Page 5 of 5