Phlebotomy Technician Certification

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Phlebotomy Technician Certification
Phlebotomy Technician Certification
What does a Phlebotomy Technician do?
The Phlebotomist is a vital member of the clinical laboratory team, whose main function is to obtain patient’s blood specimens by venipuncture and micro collection. They usually work under the supervision of medical technologists or laboratory managers. Phlebotomists
are employed throughout the health care system – hospitals, neighborhood health center, medical group practices, HMO’s, public health
facilities, veteran hospitals, insurance carriers and in other health care settings. The field of Phlebotomy has greatly expanded in the
past several years, and the role of this integral member of the health care team has recently been brought into much sharper focus.
Phlebotomy Technician Certification Program
Note: For students enrolled in the Patient Care Technician Program, the Phlebotomy Technician Certification course is considered Part
One, Patient Care Technician.
Phlebotomy Technician Certification Program
(PLAB-1023)
Total
96 hours
96 hours
Course prerequisites MUST be completed prior to registration.
Upon successful completion of this program, the student is eligible to take the National Center for Competency Testing, NCCT,
certification exam for Phlebotomy Technician.
Phlebotomy Technician Certification Program Prerequisites
Registration must be done in person.
• High School Diploma or equivalent
• Brookhaven College Continuing Education-Immunization Record Form
Brookhaven College will require a copy of proof of immunization. Immunizations must be current.
The Immunization Record must be completed and signed ONLY by Brookhaven College’s Health Center nurse. The student must
provide proof of immunization and have completed a Brookhaven College Continuing Education-Immunization Record Form.
The following immunizations are required: Measles, Mumps, Rubella (MMR), Varicella, TD or TDAP, all 3 doses of the Hepatitis B
series, Flu Shot, and a current TB test (within the last year). If students have had a previous positive PPD test, documentation or
history of treatment is required.
• A copy of current completion card of Basic Cardiac Life Support, BCLS, for Health Care Providers
• A copy of valid U.S. or Texas State Government Issued Photo I.D. (e.g. driver’s license)
• A copy of proof of personal healthcare insurance coverage, which will cover the course dates prior to enrolling
• Pass a criminal background check and drug screens*
(Students accepted into the Brookhaven College Workforce and Continuing Education Health Programs are required by the Dallas-Fort Worth
Hospital Council Member Facilities to undergo a criminal background check and drug screening prior to beginning their clinical experience.
These checks must be completed no more than 30 days before the start of the clinical experience.)
* Students who do not pass these two requirements will not be allowed to continue on to clinicals.
• Dallas County Community College District, Continuing /Workforce Education Registration Form
The following are not included in the cost of the Phlebotomy Technician Certification Program and are the responsibility of the
student.
• Textbooks
• The National Center for Competency Testing, NCCT, certification exam for Phlebotomy Technician
• Liability insurance (MUST be paid at the time of registration)
• Personal healthcare insurance coverage
• Drug Screens and Criminal Background check
• Uniform scrubs (any color and style)
For additional information about the Phlebotomy Technician Program,
please call Susana Ruelas at 972-860-7846.
SMART STARTS HERE
Workforce and Continuing Education
3939 Valley View Lane, Farmers Branch, Dallas, TX 75244-4997 | Student Services Center, Building S
[email protected] | 972-860-4600 | www.BrookhavenCollege.edu
Brookhaven College is proud to be an Hispanic-Serving Institution with more than 25 percent Hispanic student enrollment since 2006. Educational and employment opportunities are offered by Brookhaven College
without regard to race, color, age, national origin, religion, sex, disability, sexual orientation or genetic information. M&PI Office, February 2014, Job #140165, ow
Phlebotomy Technician Certification Program and Patient Care Technician, Part One Registration Packet COVER SHEET Brookhaven College Workforce and Continuing Education Division The 96-­‐hour Phlebotomy Technician Certification Program prepares professionals to collect blood specimens from clients for laboratory analysis. Students will become familiar with all aspects of blood collection and develop comprehensive skills to perform venipunctures competently and safely. Classroom work includes terminology; anatomy; physiology; blood collection procedures; specimen hands-­‐on practice; and, clinical training in skills and techniques to perform puncture methods. The program also includes lab exercises. Students will work with a training arm and other exercises intended to prepare them to function as entry-­‐level phlebotomy technicians. The curriculum is designed to provide the educational information and competencies required by the National Center for Competency Testing, NCCT, for certification as a Phlebotomy Technician. Note: For students enrolled in the Patient Care Technician Program, the Phlebotomy Technician Certification course is considered Part One, Patient Care Technician. Your registration packet includes the following: 1. Phlebotomy Technician Certification Program and Patient Care Technician, Part One Registration Packet Cover Sheet 2. Phlebotomy Technician Certification Program Requirements Sheet 3. Drug Screens and Criminal Background Check Sheet 4. Phlebotomy Technician Certification Program and Patient Care Technician, Part One Student Checklist 5. Brookhaven College Continuing Education-­‐Immunization Record Form 6. Dallas County Community College District, Workforce and Continuing Education Registration Form Helpful Information Step 1 – Please take your immunization records to our Health Center located inside the Student Services Center, Building S, Room S072.The Brookhaven College nurse MUST complete the Immunization Record form before you can register for this program. If you are missing any immunizations, ask the nurse for a list of shots with which she can assist you. TITER tests can be taken to confirm that you have the required immunizations. The Brookhaven College Health Center offers two different Hepatitis series. The most common one requiring up to six months to complete or the TWINRIX series that can be completed within 21 days. Step 2 – Once the Immunization Record has been completed and signed, take all required documentation (see student checklist) to the Health Careers Office located in Building W, Room W109. The office hours are 9 a.m.-­‐6 p.m., Monday-­‐Thursday and 9 a.m.-­‐4 p.m. on Friday. No appointment is necessary. A representative will review and approve your documentation. You will receive a completed Registration Permission Slip. Step 3 – Take the Registration Permission Slip and DCCCD, Continuing/Workforce Education Registration Form to the Admissions Office located in Building S, to register for your classes. Step 4 – Take your receipt to the Cashier’s window to pay for your courses. Payment is due at the time of registration. Note: •
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Liability Insurance MUST be paid at the time of registration. Students MUST provide their own persona health insurance coverage prior to registration that covers the dates the class is in session. Criminal Background Check and Drug Screens – required to be completed no more than 30 days before the start of the clinical experience. Driver’s license, Passport or State/Military issued ID card is required. (You will be required to present one of these forms of ID at the time you take the NCCT Phlebotomy Technician Exam.) Some classes meet at Texas Health Resources University located at 8194 Walnut Hill Lane, Dallas, TX. For additional information about the Phlebotomy Technician Certification Program or Patient Care Technician, Part One please call Susana Ruelas at 972-­‐860-­‐7846. Phlebotomy Technician Certification Program and Patient Care Technician, Part One REQUIREMENTS Phlebotomy Technician Certification Program Phlebotomy Technician Certification (PLAB-­‐1023) 96 hours Total 96 hours Course prerequisites MUST be completed prior to registration. Upon successful completion of this program, the student is eligible to take the National Center for Competency Testing, NCCT, certification exam for Phlebotomy Technician. Phlebotomy Technician Certification Program Prerequisites/Requirements Registration must be done in person. • High School Diploma or equivalent • Brookhaven College Continuing Education-­‐Immunization Record Form Brookhaven College will require a copy of proof of immunization. Immunizations must be current. The Immunization Record must be completed and signed ONLY by Brookhaven College’s Health Center nurse. The student must provide proof of immunization and complete a Brookhaven College Continuing Education-­‐Immunization Record Form. The following immunizations are required: Measles, Mumps, Rubella (MMR), Varicella, TD or TDAP, all 3 doses of the Hepatitis B series, Flu Shot, and a current TB test (within the last year). If students have had a previous positive PPD test, documentation or history of treatment is required. •
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A copy of current completion card of Basic Cardiac Life Support, BCLS, for Health Care Providers A copy of personal healthcare insurance coverage, which will cover the dates classes meet A copy of valid U.S. or Texas State Government Issued Photo I.D. (e.g. driver’s license) Pass a criminal background check and drug screens* (Students accepted into the Brookhaven College Workforce and Continuing Education Health Programs are required by the Dallas-­‐Fort Worth Hospital Council Member Facilities to undergo a criminal background check and drug screening prior to beginning their clinical experience. These checks must be completed no more than 30 days before the start of the clinical experience.) * Students who do not pass these two requirements will not be allowed to continue on to clinicals. Dallas County Community College District, Continuing /Workforce Education Registration Form The following are not included in the cost of the Phlebotomy Technician Certification Program and are the responsibility of the student. •
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Textbooks National Center for Competency Testing, NCCT, certification exam for Phlebotomy Technician Liability insurance (MUST be paid at the time of registration) Personal healthcare insurance coverage Drug Screens and Criminal Background check Uniform scrubs (any color and style) Phlebotomy Technician Certification Program and Patient Care Technician, Part One Program DRUG SCREENS AND CRIMINAL BACKGROUND CHECK Drug Screens The Brookhaven College WCE and/or a clinical agency reserve the right to remove a student from the classroom or clinical facility for suspicion of drug or alcohol use and to submit to a drug and alcohol screen at the student’s expense. Additionally, the college and/or clinical agency reserve the right to request that a student submit to a drug and alcohol screen at random at the student’s expense. Students with a positive drug screen without an authorized provider prescription or a positive alcohol screen will be removed from Brookhaven College WCE Health Program. Failure to comply with a drug screen request form Brookhaven or one of its clinical agencies will result in the student’s immediate expulsion from the Brookhaven College. Furthermore, regardless of testing or testing results, clinical agencies reserve the right to expel students from their facilities. The drug screen follows National Institute on Drug Abuse guidelines and screens for 10 substances, as designated in the Substance Abuse Panel 10, “SAP 10.” These substances are: amphetamines, barbiturates, benzodiazepines, cocaine metabolites, alcohol, marijuana metabolites, methadone, opiates, phencyclidine and propoxyphene. SAP 10 test results that fall outside of any of the acceptable ranges are considered positive test results and are automatically sent for a separate confirmatory test by a gas chromatography mass spectrometry method. If these results are positive, the test results are sent to a medical review officer who will review the results at an additional cost to the student. The medical review officer will then contact the student to determine if there is a valid prescription for the drug in question. If a valid prescription exists and is verified, the test result will be deemed negative and acceptable. An individual with a positive drug screen will not be allowed to enroll in any health related continuing education courses for a minimum of 12 months according to the Community Standard. Prior to enrolling or returning to the clinical agency/rotation, a student must provide proof of a negative drug screen as verified by the college/school. Failure to comply with this policy will result in disciplinary action and dismissal from Brookhaven College. Criminal Background Check The criminal-­‐background check reviews a person’s criminal history at least seven years prior to the date of program application. The check will include all cities and counties of the person’s residency during that time period. The following histories will disqualify an individual from consideration for a clinical rotation: • felony convictions; • misdemeanor convictions or felony deferred adjudications involving crimes against persons, e.g. physical or sexual abuse; • misdemeanor convictions related to moral turpitude, e.g. prostitution, public lewdness/exposure, etc.; • felony deferred adjudications for the sale, possession, distribution, or transfer of narcotics or controlled substances; or • status as a registered sex offender. Phlebotomy Technician Certification Program and Patient Care Technician, Part One Program STUDENT CHECKLIST All forms in this packet must be completed and approved prior to registration. Last Name__________________________________ First Name ____________________________________ Course and Section Number ___________________________ Semester___________________________ Please bring the following documentation to the Brookhaven College Workforce and Continuing Education Health Careers Office. The Health Careers Office is located in Building W, Room W109. Business hours are, Monday – Thursday, 9 a.m. -­‐ 6 p.m. and Friday, 9 a.m. – 4 p.m. No appointment is necessary. 0 Copy of your High School Diploma or equivalent 0 Brookhaven College Continuing Education-­‐Immunization Record Form 0 A copy of current Basic Cardiac Life Support, BCLS, for Health Care Providers completion card 0 A copy of current personal healthcare insurance coverage covering the dates classes will meet 0 A copy of valid U.S. or Texas State Government Issued Photo I.D. (e.g. driver’s license) 0 Dallas County Community College District, Continuing /Workforce Education Registration Form For WCE Health Careers Office Use Only: Registration Permission Slip approved by: _______________________________________________ Date: _______________ Time: ________________ (Signature) Brookhaven College Continuing Education - Immunization Record
Last Name
First Name
Date of Birth
Sex:
M
F
Middle Initial
Student ID #
Program __________________
*Please have the BHC Center Nurse/ Physician / Nurse Practitioner initial form.
MEASLES (Rubeola)
HEPATITIS B / Twinrix (Hep A/B)
Select option 1 or 2 and provide requested documentation.
1.
Dates of immunization: Two (2) are required.
A. First immunization with live attenuated virus. (Given
after 1957 and given on or after student’s first birthday).
B. Second dose separated by 28 days or more.
Date of immunization:
/
/
(
)*
2. Date of blood titer:
AND
Quantitative result #:
/
/
/
(
/
)*OR
(
1. Date of immunization:
/
/
(
)*
2. Date of immunization:
/
/
(
)*
3. Date of immunization:
/
/
(
)*
4. Date of blood titer:
)*
)* AND
VARICELLA
Dates of immunization: Two (2) are required.
a. First immunization with live attenuated virus. (Given
after 1957 and given on or after student’s first birthday).
Date of immunization:
/
/
(
)*
/
/
/
/
(
(
)*OR
)*
1. 2 Doses (30 days apart or more)
/
/
(
)*
2. Date of blood titer:
AND
Quantitative result #:
/
/
/
/
(
(
)*
)*
*TITER OR VACCINATION REQUIRED FOR NURSING/
RADIOLOGY/ EMS
RUBELLA (German Measles)
TB
Select option 1 or 2 and provide requested documentation.
1.
(
*** TITER REQUIRED FOR PARAMEDIC***
Select option 1 or 2 and provide requested documentation.
2. Date of blood titer:
Quantitative result #:
/
Quantitative result #
MUMPS
1.
/
First immunization with live attenuated virus.
(Given after 1957 and given on or after student’s
first birthday).
PPD
Date:
Result :
/
Negative
/
(
Positive
)*
mm. (
)*
Date of immunization:
/
/
(
/
)*
2. Date of blood titer:
Quantitative result #:
/
/
/
(
(
)*
Chest X Ray Date:
Result :
MMR
1. Date of immunization:
/
/
(
)*
2. Date of immunization:
/
/
(
)*
FLU VACCINATION
1. Seasonal Flu Shot:
/
OR
)*OR
/
Negative
/
/
(
Positive (
)*
)*
***WITHIN THE LAST YEAR AND YEARLY THEREAFTER***
Tdap/ tetanus, diphtheria and acellular pertussis
(Within 10 years for ALL students).
(
)*
1. Date of immunization:
/
/
(
)*
BHC Center Nurse/ Physician / Nurse Practitioner Signature
SIGNATURE:
DATE:
UPDATED 12/03/2014
Continuing/Workforce Education Registration
Educational opportunities are offered by the Dallas County Community College District without regard to race, color, age, national origin, religion, sex,
disability or sexual orientation.
Please check the college you plan to attend.
Brookhaven College
Cedar Valley College
Eastfield College
El Centro College (ECC)
3939 Valley View Lane
Farmers Branch, TX 75244-4997
972-860-4600
3030 North Dallas Avenue
Lancaster, TX 75134-3799
972-860-8210 fax 972-860-8033
3737 Motley Drive
Mesquite, TX 75150-2099
972-860-7113 fax 972-860-8306
Main & Lamar Streets
Dallas, TX 75202-3604
214-860-2147 fax 214-860-2124
Mountain View College
North Lake College
Richland College
ECC-Bill J. Priest Campus
4849 West Illinois Avenue
Dallas, TX 75211-6599
214-860-8835 fax 214-860-8570
5001 N. MacArthur Blvd.
Irving, TX 75038-3899
972-273-3360 fax 972-273-3378
12800 Abrams Road
Dallas, TX 75243-2199
972-238-6144 fax 972-238-6149
1402 Corinth Street
Dallas, TX 75215-2111
214-860-5700 fax 214-860-5870
Dallas TeleCollege
9596 Walnut Street
Dallas, TX 75243-2112
972-669-6400 fax 972-669-6409
Student Information
Please print.
* Please check appropriate box; your responses to these questions are voluntary - information is used to meet Texas State reporting requirements only.
New Student
Existing Student
* Male
* Female
*Social Security Number: _______-______-________
DCCCD Student I.D. Number: ___________________
Ethnicity information is used to meet Texas State reporting requirements and providing this information is voluntary on your part.
White, Non-Hispanic
Black, Non-Hispanic
Hispanic
Asian/Pacific Islander
Last Name
American Indian/Alaskan Native
International/Non-Immigrant
First Name
Other
No Response
MI
Address
City
State
Zip
Home Phone
Work Phone
County
Country
Cell Phone
Fax
E-mail Address _____________________________
I verify that the above information is accurate.
Date of Birth ____________________
Signature________________________________________
Date_____________
Course Information (Certain Continuing Education courses have entrance requirements that student must meet prior to registration.
Consult college for details.)
REG #
TERM
COURSE #
SECTION #
COURSE TITLE
DAYS
DATES
TIME
LOCATION
FEE
Payment Information
You are able to pay by credit card on the web if you have previously registered and provided your e-mail address.
If paying by check, include Driver’s License Number and State on the top of the check, not on this form.
Refund Policy: A refund of 100 percent will be made if requested prior to the first scheduled meeting day. Your request for a refund must be made during business hours
prior to the first day of class to qualify for a 100 percent refund. A refund of 80 percent is allowed before the close of business on the day of the second class meeting. No
refund is allowed after the second class meeting. Should the college cancel the class a 100 percent refund will be issued. Refunds may take up to four weeks to process.
The Colleges of the Dallas County Community College District reserve the right to make changes that may include, but are not limited to, the days and times courses are
offered, classroom location, instructors who teach the course, and cancellation of courses.
Third Attempt to Enroll in a Course: Effective for Fall Semester 2005, the Dallas County Community Colleges will charge a higher tuition rate to students registering the third
or subsequent time for a course. All third and subsequent attempts of the majority of credit and Continuing Education/Workforce Training courses will result in higher tuition
to be charged. Developmental Studies and some other courses will not be charged a higher tuition rate. Third attempts include courses taken at any of the Dallas County
Community Colleges since the Fall 2002 semester.
FORM NO. 0817-08/06

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