Surgical Technology

Application Process

Application Checklist

Student Name:

Acknowledgement of Completion:

Program application form

Community service form

Admission advisement certificate of attendance

Job shadow form

Criminal background check disclosure/consent form

Review and self-assessment of performance standards

BLS/AED certification achievement card

Health certification requirements:

• Immunizations:
  • MMR immunizations 1 and 2 or rubella titer
  • Rubeola immunization or titer
  • Chicken pox – proof of having chicken pox or chicken pox immunization per authorized medical signature or varicella titer
  • Influenza immunization
  • Meningitis immunization
• TB skin test – 1 month prior to program start
• Hepatitis B vaccination (series of 3) Signed verification of Hepatitis B status or declination
• DTAP – Diphtheria, tetanus and pertussis immunization