INFORMATION FOR STUDENTS

Transcription

1 INFORMATION FOR STUDENTS PREVIOUSLY ENROLLED IN ANOTHER DENTAL HYGIENE PROGRAM Thank you for your interest in the Lorain County Community College s (LCCC) Dental Hygiene program. Please be aware that, in order to receive transfer credit for any previously completed Dental Hygiene courses/clinics/labs, you must have attained a grade of C or higher for all previously attempted dental hygiene courses. Students who are not granted transfer credit for dental hygiene courses (after fulfilling all Process steps identified below) are required (if selected for admission) to complete those Dental Hygiene curriculum courses, should they apply to the program as a new student and fulfill all Dental Hygiene curriculum requirements as a new Dental Hygiene Student. THERE ARE NO EXCEPTIONS TO THIS POLICY. PROCESS: Prior to seeking transfer credit for dental hygiene courses/clinics, a student must complete a valid LCCC Application and have it on file, in the LCCC Records Office, and transcripts indicating that all admission requirements have been fulfilled. Once the LCCC Application is on file, submit the following items to Dr. Susan Leiken, Dental Hygiene Program Director, located in the Health Sciences Building, room 223. A list of Dental Hygiene courses completed, along with course outlines, or syllabi. A letter of support from the previous Dental Hygiene Program Director and include completed FERPA release form below. Two (2) transfer Dental Hygiene student reference forms completed by Dental Hygiene faculty who are familiar with your academic record and include FERPA release forms below. Once all of the FERPA forms have been completed, LCCC will send the reference forms to the faculty designated by the applicant. A personal statement of the reason(s) for transfer. Please include institutional documentation of your performance status (i.e. course grades) for all courses, clinical courses, and labs. Additionally, please include performance status of all courses, clinical courses, and labs from which you may have withdrawn. POLICIES If the documentation supports course equivalency, the Program Director will notify the LCCC Associate Registrar and clinical transfer credit will be posted to the student s academic record. Students who are granted transfer credit for clinical coursework should then meet with the Dental Hygiene Program Director and Counselor, to compete a Dental Hygiene Progression Request form. Transfer students are admitted to the program per review of transfer information and completion of criteria identified in the process steps (above), and on a space available basis. All transfer students must meet the 20 credit hour residency requirement in order to obtain the Associate of Applied Science in Dental Hygiene degree. Created 5/05/09

2 FERPA RELEASE Dental Hygiene Program Director (from previous Dental Hygiene program) LORAIN COUNTY COMMUNITY COLLEGE 1005 N. Abbe Rd. North Elyria, OH Name: (Print Name) (not an LCCC Dental Hygiene Student-previous dental hygiene student at ) In accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA), I, the undersigned, hereby authorize Name- Previous Dental Hygiene Program Director Name-Dental Hygiene Program to provide a written and/or verbal reference in which he/she may reference the following educational records and information for the purpose of providing a recommendation for employment, college application, scholarship, etc. Indicate Type of Record To Be Released: [Example: grades, GPA, class rank, academic standing, academic performance, professional behavior traits, code of conduct complaints and/or violations, etc.] Grades, GPA, class rank, academic standing, academic performance, professional behavior traits, code of conduct complaints and/or violations, etc. All materials pertaining to above student s tenure as a dental hygiene student in the Dental Hygiene Program at:

3 Name and Address of Receiving Party: Dr. Susan Leiken, Director Dental Hygiene Program Lorain County Community College 1005 N. Abbe Rd. Elyria Ohio (440) (440) Fax I understand further that: 1) I have the right not to consent to the release of my education records; 2) I have the right to receive a copy of such records upon request; and 3) that this consent shall remain in effect for one year from the date signed, unless revoked by me prior to one year from the date signed, but that any such revocation shall not affect disclosures previously made by Lorain County Community College, prior to the receipt of any such written revocation. I waive my right to review a copy of the letter or recommendation at any time in the future. THIS INFORMATION IS RELEASED SUBJECT TO THE CONFIDENTIALITY PROVISIONS OF FERPA AND OTHER APPROPRIATE STATE AND FEDERAL LAWS AND REGULATIONS, WHICH PROHIBITS ANY FURTHER DISCLOSURE OF THIS INFORMATION WITHOUT THE SPECIFIC WRITTEN CONSENT OF THE PERSON TO WHOM IT PERTAINS, OR AS OTHERWISE PERMITTED BY SUCH REGULATIONS. Student s Signature Date cc: [Receiving Party] Revised 6/19/09

4 FERPA RELEASE Dental Hygiene Faculty #1 (from previous Dental Hygiene program) LORAIN COUNTY COMMUNITY COLLEGE 1005 N. Abbe Rd. North Elyria, OH Name: (Print Name) (not an LCCC Dental Hygiene Student-previous dental hygiene student at ) In accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA), I, the undersigned, hereby authorize Name- Previous Dental Hygiene Faculty Name-Dental Hygiene Program to provide a written and/or verbal reference in which he/she may reference the following educational records and information for the purpose of providing a recommendation for employment, college application, scholarship, etc. Indicate Type of Record To Be Released: [Example: grades, GPA, class rank, academic standing, academic performance, professional behavior traits, code of conduct complaints and/or violations, etc.] Grades, GPA, class rank, academic standing, academic performance, professional behavior traits, code of conduct complaints and/or violations, etc. All materials pertaining to above student s tenure as a dental hygiene student in the Dental Hygiene Program at:

5 Name and Address of Receiving Party: Dr. Susan Leiken, Director Dental Hygiene Program Lorain County Community College 1005 N. Abbe Rd. Elyria Ohio (440) (440) Fax I understand further that: 1) I have the right not to consent to the release of my education records; 2) I have the right to receive a copy of such records upon request; and 3) that this consent shall remain in effect for one year from the date signed, unless revoked by me prior to one year from the date signed, but that any such revocation shall not affect disclosures previously made by Lorain County Community College, prior to the receipt of any such written revocation. I waive my right to review a copy of the letter or recommendation at any time in the future. Student s Signature Date THIS INFORMATION IS RELEASED SUBJECT TO THE CONFIDENTIALITY PROVISIONS OF FERPA AND OTHER APPROPRIATE STATE AND FEDERAL LAWS AND REGULATIONS, WHICH PROHIBITS ANY FURTHER DISCLOSURE OF THIS INFORMATION WITHOUT THE SPECIFIC WRITTEN CONSENT OF THE PERSON TO WHOM IT PERTAINS, OR AS OTHERWISE PERMITTED BY SUCH REGULATIONS. cc: [Receiving Party] Revised 6/19/09

6 FERPA RELEASE Dental Hygiene Faculty #2 (from previous Dental Hygiene program) LORAIN COUNTY COMMUNITY COLLEGE 1005 N. Abbe Rd. North Elyria, OH Name: (Print Name) (not an LCCC Dental Hygiene Student-previous dental hygiene student at ) In accordance with the Family Educational Rights and Privacy Act of 1974 (FERPA), I, the undersigned, hereby authorize Name- Previous Dental Hygiene Faculty Name-Dental Hygiene Program to provide a written and/or verbal reference in which he/she may reference the following educational records and information for the purpose of providing a recommendation for employment, college application, scholarship, etc. Indicate Type of Record To Be Released: [Example: grades, GPA, class rank, academic standing, academic performance, professional behavior traits, code of conduct complaints and/or violations, etc.] Grades, GPA, class rank, academic standing, academic performance, professional behavior traits, code of conduct complaints and/or violations, etc. All materials pertaining to above student s tenure as a dental hygiene student in the Dental Hygiene Program at:

7 Name and Address of Receiving Party: Dr. Susan Leiken, Director Dental Hygiene Program Lorain County Community College 1005 N. Abbe Rd. Elyria Ohio (440) (440) Fax I understand further that: 1) I have the right not to consent to the release of my education records; 2) I have the right to receive a copy of such records upon request; and 3) that this consent shall remain in effect for one year from the date signed, unless revoked by me prior to one year from the date signed, but that any such revocation shall not affect disclosures previously made by Lorain County Community College, prior to the receipt of any such written revocation. I waive my right to review a copy of the letter or recommendation at any time in the future. Student s Signature Date THIS INFORMATION IS RELEASED SUBJECT TO THE CONFIDENTIALITY PROVISIONS OF FERPA AND OTHER APPROPRIATE STATE AND FEDERAL LAWS AND REGULATIONS, WHICH PROHIBITS ANY FURTHER DISCLOSURE OF THIS INFORMATION WITHOUT THE SPECIFIC WRITTEN CONSENT OF THE PERSON TO WHOM IT PERTAINS, OR AS OTHERWISE PERMITTED BY SUCH REGULATIONS. cc: [Receiving Party] Revised 6/19/09

8 LORAIN COUNTY COMMUNITY COLLEGE DENTAL HYGIENE PROGRAM DENTAL HYGIENE FACULTY REFERENCE FORM #1 (This Form Is To Be Completed by A Dental Hygiene Faculty Member who is familiar with student and student s academic record) has applied to the Lorain County Community College s Dental Hygiene Program. Student Name previously enrolled in your dental hygiene program Please indicate in the apporpriate column your evaluation of the student, when enrolled in your dental hygiene program. E-EXCELLENT G-GOOD F-FAIR P-POOR X-UNKNOWN PERSONAL QUALITIES E G F P X COMMENTS ADHERENCE TO APPEARANCE PROTOCOL Initiative Acountability Adherence to program s Code of Conduct Ethical/integrity Adherence to program s Attendance Policy Respectful interactions Amenable to Cooperating and collaborating with others PROFESSIONAL PERFORMANCE Knowledge of the Dental Hygiene Assessment Process when treating patients Dental Hygiene Instrumentation skills Ability to demonstrate critical thinking skills while treating patients Adherence to Infection Control Policies Knowledge of charting and documentation policies Computer skills E G F P X COMMENTS

9 LORAIN COUNTY COMMUNITY COLLEGE DENTAL HYGIENE PROGRAM DENTAL HYGIENE FACULTY REFERENCE FORM #2 (This Form Is To Be Completed by A Dental Hygiene Faculty Member who is familiar with student and student s academic record) has applied to the Lorain County Community College s Dental Hygiene Program. Student Name previously enrolled in your dental hygiene program Please indicate in the apporpriate column your evaluation of the student, when enrolled in your dental hygiene program. E-EXCELLENT G-GOOD F-FAIR P-POOR X-UNKNOWN PERSONAL QUALITIES E G F P X COMMENTS ADHERENCE TO APPEARANCE PROTOCOL Initiative Acountability Adherence to program s Code of Conduct Ethical/integrity Adherence to program s Attendance Policy Respectful interactions Amenable to Cooperating and collaborating with others PROFESSIONAL PERFORMANCE Knowledge of the Dental Hygiene Assessment Process when treating patients Dental Hygiene Instrumentation skills Ability to demonstrate critical thinking skills while treating patients Adherence to Infection Control Policies Knowledge of charting and documentation policies Computer skills E G F P X COMMENTS