EXPANDED FUNCTION DENTAL ASSISTANT (EFDA) APPLICATION

Transcription

1 EXPANDED FUNCTION DENTAL ASSISTANT (EFDA) APPLICATION Lancaster County Career & Technology Center 1730 Hans Herr Drive P.O. Box 527 Willow Street, PA Revised June 13, 2017

2 Dear Prospective EFDA Student, Thank you for your interest in LCCTC s Expanded Function Dental Assistant program. We are pleased that you are thinking about advancing your career as a dental professional while meeting the future needs of dentistry. This program is approved by the PA State Board of Dentistry, and is designed in accordance with their EFDA guidelines. The total length of the program is 210 hours, which consists of 90 hours of didactic (classroom) and laboratory training, followed by a minimum of 120 hours of clinical externship in a dental office. You will perform EFDA assistant duties detailed in the Pennsylvania Law. You will learn to place, contour, and finish amalgams and composite restorations; place and remove matrices, wedges, and rubber dams, coronal polish, apply fluoride, improve temporary and impression skills; and, apply bases and liners. Classes will be Mondays and Wednesdays in the fall and Tuesday and Thursday in the spring 6:00 9:00pm. Clinical externship may require daytime hours, and may be performed in the dental office where you are currently employed, or at another site procured by you and approved by the program Director or Instructor. As a requirement of the entrance process, please complete the following application. A program admissions checklist will also be provided to you, along with the anticipated costs (listed below) associated with the program, to insure all of the appropriate documentation and payments are completed and received. Registration Fee: $20 Board Application Processing Fee: $20 Program Tuition: $3,565 Additional Out of Pocket costs for textbooks and materials may apply. If your office does not use amalgam there is a $50 materials fee for amalgam, Copalite and use of our amalgam instruments. If you do not have a dental office or your dentist does not want to provide materials, there is a $190 materials fee to use our materials and instruments. Please advise us as soon as possible so that we may order materials. Application to the State Board of Dentistry is $75 This program is not eligible for government based financial aid. Thank you again for your interest in Lancaster County Career & Technology Center. We look forward to working with you. If you have any questions, please contact: Elizabeth Scott Adult Education Registrar escott@lancasterctc.edu

3 EXPANDED FUNCTION DENTAL ASSISTING PROGRAM APPLICATION Date of Application: / / Gender: Male Female Name (Please Print): First Middle Last (Maiden) Address: Primary Phone Number: (Home/Cell/Work) (Day/Evening) Alternate Phone Number: (Home/Cell/Work) (Day/Evening) Social Security #: Date of Birth: / / School District of Residency: Emergency Contact Information: Name: Relationship: Phone Number: Work History *Candidates must have minimum of one (1) year experience as a full time Dental Assistant (chair side), and submit a Letter of Verification from their current or past employer. Current Employer: Dates Employed: From: / To / Contact: Will your employer or another organization be assisting you with funding? Yes No Previous Employer: Dates Employed: From: / To / Contact: Previous Employer: Dates Employed: From: / To / Contact: Signature: Please return all forms to: Lancaster County CTC Adult Registrar; 1730 Hans Herr Drive; Willow Street, PA 17584

4 EXPANDED FUNCTION DENTAL ASSISTANT ADMISSIONS CHECKLIST Name (Please Print): First Middle Last (Maiden) Address: Phone: (Home/Cell/Work) (Day/Evening) (Please return with application) Program application submitted Employer Verification Letter submitted (Must be on company letterhead, verifying at least one (1) year of employment as a chair side Dental Assistant.) Copy of PA State Radiology Board Certificate submitted Documentation of completion of an accredited Dental Assistant program or CDA or RDH certification (If applicant is an office trained DA with no CDA, a pre entrance exam will be required prior to acceptance.) Additional Materials Required Will supply my own materials Will use LCCTC materials with cost added to invoice. (LCCTC to be notified at least 2 weeks prior to start of class) * EFDA Kit ($190) * Amalgam, Copalite and instruments ($50) Initial tuition payment submitted (Amount $ ) (A minimum payment of ½ of the program tuition, plus all materials and supplies, is due on/before the first day of class. The remaining balance must be paid prior to starting the clinical component of the EFDA program.) 1. Registration Fee ($20) 2. State Board Application Processing Fee ($20) 3. Program PAID IN FULL EFDA suggested kit contents and materials (employer materials); highly suggested that students bring the materials that they would be using in their own office. On the first day of class, we will lend you a tool kit that you can use for storage.

5 Instruments a basic restorative kit instruments that you use in your office. #4 or 6 round bur latch 3 ring notebook/ pen or pencil Amalgam Articulating paper Automatrix tightener if available if not, we have one here Bitine Rings, Forceps/ automatrix tightener if available if not, we have some here Brownie and greenie points latch or FG Composite bonding system Composite finishing burs FG at least egg and flame/needle shapes Composite microfilled, microfilled hybrid or nanohybrid Composite flowable with tips Composite polishing paste prisma gloss or similar material Composite polishing points enhance or other system Diamonds FG at least egg and flame/needle shapes Dycal and vitrebond or other liner Etch extracted molars with no restorations (optional) may be sterilized in the autoclave gloves/mask (optional) linen strips matrix tofflemire bands, sectional matrix &/or automatrix bands mylar strip polishing cup latch or disposable Prophy angle rubber dam material at least 10 sheets Safety glasses Loopes if available sandpaper discs(various grits) and mandrels sealant material with tips wedges an assortment white stone FG or latch Please note you can reuse burs/prophy cups, tips, wedges and points for class purposes. You will need multiple matrices because these may get too messed up to reuse. If your office does not use amalgam there is a $50 materials fee for amalgam, Copalite and use of our amalgam instruments. If you do not have a dental office or your dentist does not want to provide materials, there is a $190 materials fee to use our materials and instruments. Please advise us as soon as possible so that we may order materials.