Health Sciences Program Application Associate in Science Degree in Respiratory Care

Transcription

1 Health Sciences Program Application Associate in Science Degree in Respiratory Care For admission consideration, you must submit this application with any required documentation and have all of your grades posted to your Valencia transcript by the application deadline. Please fill in all blanks. Date of Application: Applying for (Term and Year): VID# (Required) Name (Last) (First) (Middle) Home Address City, State, Zip Primary Phone Number: Secondary Phone Number: Atlas (Admission decisions will be sent to your Atlas 5-7 weeks after the application deadline) Are you a U.S. Citizen, a U.S. permanent resident, or hold a non-immigrant visa with employment authorization? Yes No (Non-immigrant status students can visit the U.S. Department of State directory of visa categories to verify employment eligibility Are you an International Student? Yes No INTERNATIONAL STUDENTS ONLY: Have you contacted the Health Sciences Compliance Office? Yes No NOTE: International Students must complete their background check, fingerprinting, drug testing, immunizations and CPR certification at least six months in advance of the anticipated start term. You cannot submit an application until you have contacted the Health Sciences Compliance Office to begin the compliance process & background check. Health Sciences Compliance department can be reached at: HSCompliance@valenciacollege.edu Education History If you have applied to other limited access Health Sciences programs at Valencia in the past 12 months, indicate which ones: Have you applied to the Valencia Respiratory Care program before? If so, indicate for which entry terms (i.e. Spring 2017): Have you previously been accepted into a Health Sciences Program at Valencia College and subsequently deemed ineligible for return to the program? Yes No (NOTE: The selection committee has the right to contact the applicant s previous program; this information will be included in the consideration for program admission). 1

2 Education History (cont.) Please list all colleges/universities/postsecondary institutions you have attended: If you have attended other institutions outside of Valencia, have all of your official transcripts from these institutions been submitted to Valencia and posted to your Valencia record? (Check unofficial transcript in Atlas.) Yes No (Your application will be ineligible if you are missing transcripts). Are you a Career Pathways/Tech Prep Graduate from high school? Yes No (Attach documentation.) Were you selected as an Alternate for Valencia s Respiratory Care Program from the previous year? Yes No Certification and Employment Verification Do you hold a current certification or license as a Radiologic Technologist RT(R), Registered Nurse (RN), Paramedic, Certified Respiratory Therapist (CRT), Registered Cardiac Sonographer (RCS/RDCS), Registered Vascular Specialist (RVS), Registered Cardiac Electrophysiology Specialist (RCES), Cardiovascular Tech (RCVT) or Echocardiography (RCS/RDCS)? No Yes, and I have attached the appropriate documentation indicating certification and/or license in the following specialties: Are you an on-the-job-trained Respiratory Assistant with a minimum of one year of experience? No Yes, and I have attached a letter signed by my supervisor or HR representative on company letterhead. 2

3 Academics All official transcripts must be submitted to Valencia and evaluated by the application deadline, including any AP/IB/CLEP official score reports (must be requested from collegeboard.org for AP/CLEP or ibo.org for IB). Check unofficial academic transcript (Log in to Atlas Courses tab, Registration, Transcripts) to verify that transcripts have been received and evaluated by Valencia. Your application will be ineligible if you are missing any transcripts. What is your overall undergraduate college GPA, including all transfer work? COURSE CHART INSTRUCTIONS: Enter grades for courses completed with a minimum grade of C (for Humanities, highest grade should be entered). If you took science courses that have separate grades for the lecture and the lab, enter both grades. Enter AP/IB/CLEP as the grade, if applicable. You must submit official scores and we cannot accept scores from other school transcripts. Enter R as the grade if you are currently registered in a course. If you have not taken a course, please enter No or leave blank. Any blank spaces will be assumed to be courses not taken; therefore, please fill out chart carefully and completely. If you are unsure about a course, enter it for review. Valencia Course Prefix/ Number Course Prefix/ Number (if different) Credits Course Name Grades Semester & Year Taken Name of Institution Attended *BSC 2093C 4 *Human Anatomy & Physiology I *MAC *College Algebra *PHY 1007C 4 *Physics BSC 2094C 4 Human Anatomy & Physiology II MCB 2010C 4 Microbiology ENC Freshman Composition I 3 Any course (highest grade) that meets Gen. Ed. Humanities req. PSY General Psychology HSC 1004 or SLS Professions of Caring or New Student Experience HSC Medical Terminology PHI Ethics and Critical Thinking 3

4 Respiratory Care Core Performance Standards for Admission and Progression Respiratory Care is a practice discipline with cognitive, sensory, affective, and psychomotor performance requirements. Based on these requirements the following list of "Core Performance Standards" has been developed. Each standard has an example of an activity or activities, which a student will be required to perform while enrolled in the Respiratory Care Program. These standards are a part of each Respiratory Care course and of the professional role expectation of a Respiratory Therapist. For the purpose of the Respiratory Care Program, a qualified individual with a disability is one who, with or without reasonable accommodations or modifications, meets the essential eligibility requirements for participation in the program." The Division of Allied Health at Valencia makes no preadmission inquiries concerning an applicant s disability status. Information related to an applicant s disabilities is not a part of the information reviewed by the Admission Committee. These Performance Standards should be used to assist students in determining whether accommodations or modifications are necessary for the student to meet program requirements. A student who identifies potential difficulties with meeting the Performance Standards should communicate his/her concerns to an advisor in the Office for Students with Disabilities. The student has the responsibility to identify and document the disability and to request reasonable and appropriate adjustments. Determination is made on an individual basis as to whether any accommodations or modifications can be reasonably made. Issue Standard Some Examples of Necessary Activities (not all inclusive) Critical Thinking Interpersonal Communication Mobility Motor Skills Hearing Visual Tactile Critical thinking ability sufficient for clinical judgment Interpersonal abilities sufficient to interact with individuals, families, and groups from a variety of social, emotional, cultural, and intellectual backgrounds Communication abilities sufficient for interaction with others in verbal and written form Physical abilities sufficient to move from room to room and maneuver in small spaces Gross and fine motor abilities sufficient to provide safe and effective respiratory care Auditory ability sufficient to monitor and assess health needs Visual ability sufficient for observation and assessment necessary in respiratory care Tactile ability sufficient for physical assessment Identify cause-effect relationships in clinical situations, develop respiratory care plans Establish rapport with patients/clients and colleagues Explain treatment procedures, initiate health teaching, document and interpret respiratory care actions and patient/client responses Moves around in patient's rooms, work spaces, and treatment areas, administer cardio-pulmonary procedures Calibrate and use equipment; position patients/ clients Hears monitor alarm, emergency signals, auscultatory sounds, cries for help Observes patient/client responses Perform palpation, functions of physical examination and/or those related to therapeutic intervention, e.g., insertions of a catheter I have read and understand the above performance standards necessary to be a competent Respiratory Therapist. Signature Print 4

5 For admission consideration, you must submit this application with any required documentation and have all of your grades posted to your Valencia transcript by the Respiratory Care Program application deadline. DECLARATION I have reviewed all admission requirements and expectations in the Valencia Respiratory Care Program Guide. I understand that it is fraudulent to misrepresent any information on this application and I affirm that all information on this application is true. I understand that, if admitted to this program, I must submit to a criminal background check, fingerprinting and drug screening; document immunizations and other requirements for clinical participation; and be free of offenses that would disqualify me from the program. I have read and understand the performance standards necessary to be a competent Respiratory Therapist. Signature Date How to Submit Application A non-refundable Health Sciences Program Application fee of $15 must be submitted to the Business Office with each application. By mail: Please mail the application together with a check or money order payable to Valencia College to the address listed below. Do not send separately. Valencia College Business Office 4-6 PO Box 4913 Orlando, FL In-person: Please make payment by credit card, debit card, cash, check, or money order (a check or money order must be payable to Valencia College) to the Business Office on the East, West or Osceola campuses only. The Business Office locations are as follow: West Campus: SSB, Rm 101 East Campus: Bldg. 5, Rm 214 Osceola Campus: Bldg. 2, Rm 110 NOTE: A representative from the Business Office will forward your application to the College Admissions office for screening and processing. Admission Decisions All admission decisions will be sent to your Valencia ATLAS account approximately 5 to 7 weeks after the application deadline. If you are accepted you must confirm your seat via by the requested deadline, or you will jeopardize your acceptance. Admission decisions will NOT be sent via postal mail. 5