Please complete the required forms and submit to the School of Clinical Sciences Secretary, West Science Room 3515, and she will initial and date.
1. Complete the information requested on the cover page of the application form. Identify the semester and year that you will complete the practicum.
2. Complete the immunization record portion of the application form. All immunization information must be supplied and the form signed by a physician, nurse practitioner, registered nurse, or other licensed health official. You DO NOT need to supply the tuberculin test information at the time of application. The TB test must be given within 6 months of the beginning of your practicum. Please update your immunization record when the TB test is done.
NOTE: Surgical technology students must have a baseline eye exam. A signature is required and a copy of the eye exam results must be included with the application.
3. Read and sign the Hepatitis B Policy page of application form.
4. Read and sign the Verification of Policies page of application form. Be certain to read the ‘Essential Functions’ in the Policy Manual.
5. Request a recommendation from an employer and a science instructor. These recommendations are confidential and should be sent directly to the School of Clinical Sciences.Contact any Clinical Science faculty if you have questions regarding the application process.