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Emergency Medical Technician Basic

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BAKER COLLEGE Waiver Form - Office Copy Emergency Medical Technician Basic Certificate Acknowledgment Form - Limited Enrollment Programs I have received the Health Sciences Program Information and understand
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BAKER COLLEGE Waiver Form - Office Copy Emergency Medical Technician Basic Certificate Acknowledgment Form - Limited Enrollment Programs I have received the Health Sciences Program Information and understand each/all of the following: (Initial each line) Health Requirements I may be required to provide documented proof of immunization and/or titers, current Tuberculosis (TB) test results, and other screenings pertinent to my chosen career field. I am responsible for all associated cost. Declination of immunization may prevent me from clinical placement. Exposure to latex is high in the healthcare field. I should notify my advisor if I have a documented latex allergy/sensitivity. Clinical Requirements Clinical or externship experiences are based on site availability and determined by the Program Coordinator/Director/Dean of Health Sciences. Students are required to have reliable transportation to and from the assigned clinical location. Due to the limited number of clinical sites, some students may be required to travel a distance from the College. In some instances, students may need to relocate. Clinical experiences may require students to attend up to 40 hours per week. As a continuation of the student's education, the clinical experience is to be performed without remuneration. In the event a student is offered employment, this should be discussed with the Program Coordinator/Director/Dean of the Health Sciences/Dean of Health Sciences. The College provides professional liability insurance for all students during the clinical affiliation educational portion of his/her program, which covers any incident which might occur during the clinical affiliation experience. It does not cover any incident where the student is attempting to practice outside the scope of his/her education or outside the clinical affiliation site. Students are required to maintain health insurance during all clinical quarters and are responsible for any medical expenses incurred throughout the program. I may be required to submit to a drug screen as part of my clinical affiliation. I am responsible for all associated cost. Failure to comply by given deadline will result in dismissal from the program. I understand that if drugs are reported on my drug screen results, it may impact my ability to complete program requirements, including though not limited to, clinical experience. I may be required to undergo a background check, as an entrance requirement for the health program I've selected or for some clinical affiliations. I am responsible for all associated cost. I am required to complete the requirements for my background check by the specified deadline. Failure to do so may result in my being denied entry into the program, at which time my core classes may be dropped without advance notice to me. I will immediately report, in writing, any conviction, pending court action, or other recorded event not yet reported, or which subsequently occurs, to my campus program director/dean of Health Sciences/Dean of Health Sciences. A criminal record may prevent clinical placement, licensure or certification, and employment opportunities. Baker College reserves the right to deny entry into or remove from a program, any student whose background check reveals any conviction or recorded event of any nature. I may be temporarily or permanently denied financial aid funding if I have been or am subsequently convicted of the possession or sale of illegal drugs for an offense that occurred while receiving federal student aid (such as grants, loans, work-study). I may be required to undergo fingerprinting prior to clinical placement. I may be required to complete the Central Registry Clearance form prior to placement in certain clinical settings. Program Reentry Eligibility for reapplication to the program is based on previous reasons for dismissal or withdrawal and is at the discretion of the Program Coordinator/Director/Dean of Health Sciences. Readmission is not guaranteed. Reentry into some programs may be dependent upon limited program capacity and/or the availability of clinical sites. Didactic and competency testing may be required according to accreditation, state, and/or program guidelines. Retesting may involve a fee. Professionalism I must abide by the ethics and standards accepted by professionals and technicians in my chosen career field, while in all classroom and clinical settings. This includes personal conduct, professional attitude, appropriate dress, and the confidentiality of student, client, and patient information. Any breach of these standards may result in dismissal from the program. I understand that social media is prohibited in the clinical site. I agree to abstain from using personal cell phones, personal electronic devices and computers to access social media at the clinical site. I understand clinical site information is not to be discussed on any form of social network or any electronic account outside of those required by the instructor for class participation. I agree to abstain from using computers at my clinical site for personal use. Professional appearance may require a specified uniform. In all instances students are to refrain from low-cut tops, and clothing that reveals trunk skin when standing or sitting. Closed-toed shoes are required for laboratory and clinical settings. Hair, side-burns, facial hair, and nails are to be neat, clean, and trimmed to a length that will not interfere with safety and asepsis. Visible tattoos must be covered. Body piercing jewelry is not allowed. I must comply with any changes in program requirements during my course of study. Student Responsibilities: I am responsible to contact my campus Program Coordinator/Director/Dean of Health Sciences/Dean of the School of Nursing with any questions regarding program entry, reentry, retention, or completion. Essential Functions and Technical Requirements The essential functions required by the curriculum are in the following areas: motor, sensory, communication, and intellectual (conceptual, integrative, quantitative abilities for problem solving, and the behavioral and social aspects that impact the performance). Technical requirements, as distinguished from academic standards, refer to those physical, cognitive, and behavioral abilities required for satisfactory completion of all aspects of the curriculum and the development of professional attributes required by the faculty of all students at graduation. These essential functions and technical requirements are referred to as the Essential Functions. I may be required to sign an additional waiver upon entrance to my program. These Essential Functions are not conditions of admission to the College or the program. The Essential Functions provide information regarding continued eligibility in this program. A student may be qualified for and admitted to the program, but later be redirected due to a failure to develop and exhibit the Essential Functions. Persons interested in applying for admission to the program should review this information to develop a better understanding of the physical abilities and behavioral characteristics necessary to successfully complete the program. By initialing each line below, I acknowledge and understand I am expected to possess the following Essential Functions: Cognitive abilities necessary to master relevant content in courses at a level deemed appropriate by the College. These skills may be described as the ability to comprehend, memorize, analyze, and synthesize material in a timely manner. The student must maintain the minimum grade point average (GPA) determined by each program in order to continue with coursework to complete a chosen degree. Students must have a cumulative GPA of at least 2.0 to graduate from any program; however, please note that some programs require a higher GPA in order to continue with coursework. Ability to assess all information. The student must be capable of responsive and empathetic listening to establish rapport in a way that promotes openness on issues of concern and sensitivity to potential cultural differences. Emotional stability to function effectively under stress and to adapt to an environment, which may change rapidly without warning, and/or in unpredictable ways. Ability to master information presented in coursework in the form of lectures, written material, and projected images, and the ability to seek and synthesize information from appropriate and varied sources. Ability to recognize one's own limits, both personally and professionally, as related to one's skill and knowledge. Ability to effectively communicate in English, both verbally and in writing, using accurate and appropriate terminology with classmates, faculty, and individuals of all ages, races, genders, and socioeconomic, and cultural backgrounds. Ability to use computers and related technology. Ability to prioritize, organize, and utilize time management skills. Ability to identify, recognize, maintain, and disseminate accurate information. Ability to correctly interpret, and/or clarify, verbal and written communications. Ability to conduct oneself in a professional manner. Ability to think critically and demonstrate problem-solving skills. Ability to fulfill requirements of productivity and varying workloads. Ability to demonstrate appropriate professional and procedural judgment decisions. Ability to adhere to professional standards and Baker College professional conduct guidelines, policies, and procedures, including but not limited to, if at any time during a student's enrollment at Baker College, a student is charged with a felony, he/she MUST disclose this charge to a Baker College official. Failure to do so will result in immediate expulsion from the College. I have reviewed and acknowledge that I am expected to possess the program-specific Essential Functions located on the Program Information document. The faculty content expert, program official, clinical coordinator, or employment supervisor is qualified and competent to assess the student's ability to perform the Essential Functions. The College complies with the requirements and spirit of Section 504 of the Rehabilitation Act of 1973 as amended, and the Americans with Disabilities Act of 1990 (ADA), as amended by the Americans with Disabilities Act Amendments Act of 2008 (ADAAA). Therefore, the College will endeavor to make reasonable accommodations for participants with disabilities who are otherwise qualified. LIMITED ENROLLMENT CRITERIA - PROGRAM APPLICATIONS There are two sets of Limited Enrollment Criteria requirements. Please see your program advisor for which set applies to you. LIMITED ENROLLMENT CRITERIA FOR PROGRAM APPLICATIONS: Full acceptance into the professional track of some programs is limited due to clinical site availability. Students compete to earn acceptance into these programs. Selection criteria have been developed to choose the most qualified students for limited enrollment programs. Students who have successfully completed the conditional acceptance requirements for their program are eligible to apply for full acceptance into the professional track of the program. Refer to the program information supplement for program specific details on the application process, the criteria used, and the courses used in the GPA calculations. Once selected through the limited enrollment criteria, for full acceptance into a program, students must complete program requirements including, but not limited to: program specific orientations, background checks, drug screens, etc. Please contact your campus official for additional information. CRITERIA I Weighted Prerequisite GPA of Selected Courses: The program will base the majority of admission points on prerequisite grades of selected courses. Each health science program has designated specific prerequisite courses where a minimum grade requirement must be met. Refer to the program pages for this information and a listing of the identified courses to be used in the calculations below. (GPA is defined as the value on a 4.0 scale corresponding to a letter grade.) Non-Weighted Courses: required prior to program application and acceptance hold no weight in the GPA calculation for admittance must be satisfactorily completed, per program requirements are not subject to withdrawal and / or repeat policies Single-Weighted Courses: required prior to program application and acceptance provide some significant prerequisite knowledge and skills and therefore holds some weight in the GPA calculations for admittance. subject to withdrawal and / or repeat policies Double-Weighted Courses: required prior to program application and acceptance provides significant prerequisite knowledge and skills and therefore holds more weight in GPA calculations for admittance. subject to withdrawal and / or repeat Test-Out Courses: these are not weighted courses CRITERIA II Withdrawal and Repeat of Prerequisite Selected Courses: Withdraw and/or repeat of single-weighted and double-weighted prerequisite courses will result in a reduction of admission points. Refer to the program information for a listing of the identified courses to be used in the calculations below. Withdrawal: does not apply to non-weighted classes first incident of withdrawal of single-weighted and/or double-weighted courses (one or more courses in a given quarter) = forgiveness quarter with no reduction of admission points subsequent withdrawals of single-weighted and/or double-weighted courses = 5 point reduction for each weighted course withdrawn Repeats: single- and double-weighted courses only does not apply to non-weighted courses repeat courses in which a grade is earned do not receive forgiveness and will results in a 5 point reduction for each attempt exception is course greater than 60 months old repeated will not result in a loss of points CRITERIA III Entrance Exam Score: A program may require applicants to take an assessment test chosen by the College. Students may be allowed to repeat this test to improve his/her performance based upon program guidelines. Admission points will be added based on the score attained. Refer to the program requirements for entrance exam program specific information. CRITERIA IV Reapplication students who have applied for entrance into a program's professional track in the past, who had completed all program entrance requirements and prerequisite coursework at or above the minimum grade required, but were not awarded a seat due to their standing and the limited program seat capacity may reapply to the program one more time, for a maximum of two attempts. Students reapplying to the program must complete the program reapplication process. Refer to the program information for program specific information. Reapplication timeframe: Students may only be eligible to reapply within 12 months or the next application period, whichever comes first. Should two or more students obtain the same score and are applying for the last available open seat in the program, then students will be selected based on the highest overall GPA. (This includes required, single- and double-weighted courses.) Student Responsibilities: I am responsible to contact my campus Program Coordinator/Director/Dean of Health Sciences with any questions regarding program entry, reentry, retention, or completion. I may be required to sign an additional waiver upon entrance to my program. Student Name (Print) Student UIN Student Signature Date Baker College Representative Signature Date Printed: 2015/07/14 BAKER COLLEGE Waiver Form - Student Copy Emergency Medical Technician Basic Certificate Acknowledgment Form - Limited Enrollment Programs I have received the Health Sciences Program Information and understand each/all of the following: (Initial each line) Health Requirements I may be required to provide documented proof of immunization and/or titers, current Tuberculosis (TB) test results, and other screenings pertinent to my chosen career field. I am responsible for all associated cost. Declination of immunization may prevent me from clinical placement. Exposure to latex is high in the healthcare field. I should notify my advisor if I have a documented latex allergy/sensitivity. Clinical Requirements Clinical or externship experiences are based on site availability and determined by the Program Coordinator/Director/Dean of Health Sciences. Students are required to have reliable transportation to and from the assigned clinical location. Due to the limited number of clinical sites, some students may be required to travel a distance from the College. In some instances, students may need to relocate. Clinical experiences may require students to attend up to 40 hours per week. As a continuation of the student's education, the clinical experience is to be performed without remuneration. In the event a student is offered employment, this should be discussed with the Program Coordinator/Director/Dean of the Health Sciences/Dean of Health Sciences. The College provides professional liability insurance for all students during the clinical affiliation educational portion of his/her program, which covers any incident which might occur during the clinical affiliation experience. It does not cover any incident where the student is attempting to practice outside the scope of his/her education or outside the clinical affiliation site. Students are required to maintain health insurance during all clinical quarters and are responsible for any medical expenses incurred throughout the program. I may be required to submit to a drug screen as part of my clinical affiliation. I am responsible for all associated cost. Failure to comply by given deadline will result in dismissal from the program. I understand that if drugs are reported on my drug screen results, it may impact my ability to complete program requirements, including though not limited to, clinical experience. I may be required to undergo a background check, as an entrance requirement for the health program I've selected or for some clinical affiliations. I am responsible for all associated cost. I am required to complete the requirements for my background check by the specified deadline. Failure to do so may result in my being denied entry into the program, at which time my core classes may be dropped without advance notice to me. I will immediately report, in writing, any conviction, pending court action, or other recorded event not yet reported, or which subsequently occurs, to my campus program director/dean of Health Sciences/Dean of Health Sciences. A criminal record may prevent clinical placement, licensure or certification, and employment opportunities. Baker College reserves the right to deny entry into or remove from a program, any student whose background check reveals any conviction or recorded event of any nature. I may be temporarily or permanently denied financial aid funding if I have been or am subsequently convicted of the possession or sale of illegal drugs for an offense that occurred while receiving federal student aid (such as grants, loans, work-study). I may be required to undergo fingerprinting prior to clinical placement. I may be required to complete the Central Registry Clearance form prior to placement in certain clinical settings. Program Reentry Eligibility for reapplication to the program is based on previous reasons for dismissal or withdrawal and is at the discretion of the Program Coordinator/Director/Dean of Health Sciences. Readmission is not guaranteed. Reentry into some programs may be dependent upon limited program capacity and/or the availability of clinical sites. Didactic and competency testing may be required according to accreditation, state, and/or program guidelines. Retesting may involve a fee. Professionalism I must abide by the ethics and standards accepted by professionals and technicians in my chosen career field,
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