MANITOULIN-SUDBURY DSB

Transcription

1 MANITOULIN-SUDBURY DSB Pre-Employment Package Paramedic Hire Manitoulin-Sudbury District Services Board 2019 To be considered for Paramedic recruitment this pre employment package must be fully completed and submitted by Monday, March 25, 2019 at 4:30 pm. It is recommended that candidates begin compiling the contents of this package as soon as possible, to meet established time lines.

2 DOCUMENTATION Pre-hiring criterion - To be submitted by March 25, 2019 Each document submission must be accurate and complete in order to be considered for employment. Utilize Check box on right column to ensure package is complete Vulnerable Sector Check (less than 30 days old). Should the local Police Service Require an Employer s Letter of Request, contact hr@msdsb.net Complete Freedom of Communicable Diseases, Self-Declaration Form (form is attached). Copy of Ministry of Transportation 3-year Certified Statement of Driving Record (MTO abstract) (less than 30 days old). Completed MSDSB Paramedic Service Preventable Disease Physician s Certificate completed and duly signed by a Physician (form is attached). Copy of valid CPR level HCP minimum (issue date must be within one year). Clear colour photo copy of both the front and back of MTO Driver s License, authorizing operation of an ambulance in Ontario (scan must be clearly visible). Copy of Physical Evaluation Test (PET) Certification (less than 6 months old) from Cambrian College, or equivalent (Physical Evaluation Testing Booking Process form is attached). Copy of College Diploma from approved paramedic program, or formal letter from college coordinator to confirm completion date and expectation for graduation. Copy of A-EMCA, or Proof of A-EMCA examination registration (if graduate).

3 Freedom of Communicable Diseases, Self-Declaration TABLE 1 PART B Acquired Immunodeficiency Syndrome (AIDS) Amebiasis Anthrax Botulism Campylobacter enteritis Chicken Pox (Varicella) Cholera Cytomegalovirus Infection (Congenital) Diphtheria Encephalitis (Primary Viral) Gastrointesteritis Giardiasis Group A Streptococcal Disease (Invasive) Haemophilus Influenza B Disease (Invasive) Hemorrhagic Fevers including Ebola virus disease, Marburg Virus Disease and other viral causes Viral Hepatitis including Hepatitis A, B, And C Influenza Lassa Fever Legionellosis Leprosy Listeriosis Malaria Measles Viral Meningitis Meningococcal Meningitis Mumps Opthalmia Neonatorum Parathyphoid Fever Pertusssis (Whooping Cough) Plague Poliomyelitis (Acute) Psittacosis/Ornithosis Q Fever Rabies Rubella Rubella (Congenital Syndrome) Salmonellosis Shigellosis Tuberculosis Tularemia Typhoid Fever Verotoxin producing E. Coli Infections Yellow Fever Yersiniosis I (print name), am free from all communicable diseases set out in Table 1 Part B. Printed Name of Candidate: Candidate Signature Date yyyy / mm / dd

4 PREVENTABLE DISEASES PHYSICIAN S CERTIFICATE Name of Paramedic: Date of Birth: Disease Vaccination Status (Please select only one radio button for each disease) Regulatory Schedule Physician Initials for each area Tetanus & Diphtheria Vaccinated Date of Dose #3, or Booster: or Primary series (3 doses) if unimmunized Tetanus diphtheria (Td) booster doses every 10 years Polio Vaccinated - Date of Dose #3: or Primary series (3 doses) if previously unimmunized or unknown polio immunization history Pertussis Vaccinated Date of Dose #1: or 1 single dose of tetanus diphtheria acellular pertussis (Tdap) vaccine regardless of age if not previously received in adulthood Varicella (Chicken pox) Medically documented diagnosis or verification of history or, Vaccinated Date of Dose #2: or, 2 doses if no evidence of immunity Measles Vaccinated Date of Dose #2: or 2 doses where there is no laboratory evidence of immunity (regardless of age) Mumps Vaccinated Date of Dose #2: or 2 doses if no laboratory evidence of immunity Rubella Vaccinated Date of Dose: or 1 single dose if no laboratory evidence of immunity Hepatitis B Vaccinated (Vaccination with serology within 1-6 months) Last vaccination: & Serologic confirmation: or If Vaccinated is selected: 2-4 age appropriate doses, and serologic testing date within 1 to 6 months following last in the series must be documented. Printed Name of Physician Physician s Signature Date yyyy / mm / dd

5 Physical Evaluation Testing Booking Process Contact Please contact the following person at Cambrian College to book a PET Test session. All details related to exam preparation and process will be shared once your testing session has been confirmed with Cambrian College. Rob McCann Assistant Coordinator, Athletics Centre Cambrian College of Applied Arts and Technology (Sudbury Campus) 1400 Barrydowne Road, Sudbury, Ontario ext rob.mccann@cambriancollege.ca A PET Certification card will be issued to each candidate upon successful completion of the testing process. The PET certificate must be submitted with the Pre-Employment Hiring Package.