Documentation Forms
ALL Capstone Students:
AHS:
Occ Health HW
Class #5 (11/10) - Disability & the Media
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Pharmacy
1. Download the below files and print them. You will need to send all of them to the address on page 6.
2. Pharmacy Technician Application: ($40 fee)
a) Look at page 1
b) Skip pages 2-3 (hopefully page 4 does not apply)
c) Look at page 5
d) Complete pages 6 & 7.
e) Include any of the supporting documents when you apply. 3. If you do not have documentation of the information below, set up a doctor's appointment to: a) Have blood titers and documented positive immunity for: measles, mumps, rubella and varicella.
b) Provide proof of a TB test, and if positive, should have results of a negative chest x-ray.
c) Provide documentation of your last tetanus vaccine and dates of Hepatitis B vaccine.
** UPDATED INFORMATION**Once you have signed the code of conduct, confidentiality statement, received your technician license and have all of your titers / immunizations in order, you can then bring them to Ms. Borling. We will want to meet with Arnold Diaz, HR Director who resides in the Department of Pharmacy Practice, room 164 located at 833 S. Wood Street.
pharmtechlicense.pdf | |
File Size: | 40 kb |
File Type: |
student_unpaid_orientation.pdf | |
File Size: | 772 kb |
File Type: |
confidentiality_agreement_revised_9-22-05.pdf | |
File Size: | 56 kb |
File Type: |
Title Text.
Nursing
1. Download the 2 files below into UPAD (to sign electronically).
Observation Experience Checklist (ignore the part about a driver's license)
Orientation Manual
2. Review the manual and sign pages 11, 29, 31, and 33. From UPAD, email signed manual to [email protected].
3. Set up a doctor's appointment to get your immunizations checked and a TB test (see checklist).
1. Download the 2 files below into UPAD (to sign electronically).
Observation Experience Checklist (ignore the part about a driver's license)
Orientation Manual
2. Review the manual and sign pages 11, 29, 31, and 33. From UPAD, email signed manual to [email protected].
3. Set up a doctor's appointment to get your immunizations checked and a TB test (see checklist).
Social Work
1. Download the 2 files below into UPAD (to sign electronically).
Student Assent Form
Parental Consent Form
1. Download the 2 files below into UPAD (to sign electronically).
Student Assent Form
Parental Consent Form
2. After reading the documents thoroughly, sign the student form on your iPad (in UPAD) and have your parent or legal guarian sign the parental consent form.
3. Email both documents to [email protected] (please 'cc' [email protected])
3. Email both documents to [email protected] (please 'cc' [email protected])
Dentistry:
1. Download this file to UPAD. Fill it out and sign electronically.