Phlebotomy Technician Certification

Phlebotomy Technician Certification What does a Phlebotomy Technician do? The Phlebotomist is a vital member of the clinical laboratory team, whose main function is to obtain patient’s blood specimens by venipuncture and micro collection. They usually work under the supervision of medical technologists or laboratory managers. Phlebotomists are employed throughout the health care system – hospitals, neighborhood health center, medical group practices, HMO’s, public health facilities, veteran hospitals, insurance carriers and in other health care settings. The field of Phlebotomy has greatly expanded in the past several years, and the role of this integral member of the health care team has recently been brought into much sharper focus.

Phlebotomy Technician Certification Program Note: For students enrolled in the Patient Care Technician Program, the Phlebotomy Technician Certification course is considered Part One, Patient Care Technician.

Phlebotomy Technician Certification Program

(PLAB-1023)

Total

96 hours

96 hours

Course prerequisites MUST be completed prior to registration. Upon successful completion of this program, the student is eligible to take the National Center for Competency Testing, NCCT, certification exam for Phlebotomy Technician.

Phlebotomy Technician Certification Program Prerequisites Registration must be done in person. • High School Diploma or equivalent • Brookhaven College Continuing Education-Immunization Record Form Brookhaven College will require a copy of proof of immunization. Immunizations must be current. The Immunization Record must be completed and signed ONLY by Brookhaven College’s Health Center nurse. The student must provide proof of immunization and have completed a Brookhaven College Continuing Education-Immunization Record Form. The following immunizations are required: Measles, Mumps, Rubella (MMR), Varicella, TD or TDAP, all 3 doses of the Hepatitis B series, Flu Shot, and a current TB test (within the last year). If students have had a previous positive PPD test, documentation or history of treatment is required. • A copy of current completion card of Basic Cardiac Life Support, BCLS, for Health Care Providers • A copy of valid U.S. or Texas State Government Issued Photo I.D. (e.g. driver’s license) • A copy of proof of personal healthcare insurance coverage, which will cover the course dates prior to enrolling • Pass a criminal background check and drug screens* (Students accepted into the Brookhaven College Workforce and Continuing Education Health Programs are required by the Dallas-Fort Worth Hospital Council Member Facilities to undergo a criminal background check and drug screening prior to beginning their clinical experience. These checks must be completed no more than 30 days before the start of the clinical experience.)

* Students who do not pass these two requirements will not be allowed to continue on to clinicals. • Dallas County Community College District, Continuing /Workforce Education Registration Form The following are not included in the cost of the Phlebotomy Technician Certification Program and are the responsibility of the student. • Textbooks • The National Center for Competency Testing, NCCT, certification exam for Phlebotomy Technician • Liability insurance (MUST be paid at the time of registration) • Personal healthcare insurance coverage • Drug Screens and Criminal Background check • Uniform scrubs (any color and style)

For additional information about the Phlebotomy Technician Program, please call Susana Ruelas at 972-860-7846. SMART STARTS HERE

Workforce and Continuing Education

3939 Valley View Lane, Farmers Branch, Dallas, TX 75244-4997 | Student Services Center, Building S [email protected] | 972-860-4600 | www.BrookhavenCollege.edu

Brookhaven College is proud to be an Hispanic-Serving Institution with more than 25 percent Hispanic student enrollment since 2006. Educational and employment opportunities are offered by Brookhaven College without regard to race, color, age, national origin, religion, sex, disability, sexual orientation or genetic information. M&PI Office, February 2014, Job #140165, ow

Phlebotomy  Technician  Certification  Program     and   Patient  Care  Technician,  Part  One   Registration  Packet                                                                                                                                                                                                                                                                                                COVER  SHEET   Brookhaven  College                                                                                                                                                           Workforce  and  Continuing  Education  Division    

The  96-­‐hour  Phlebotomy  Technician  Certification  Program  prepares  professionals  to  collect  blood  specimens  from  clients  for   laboratory  analysis.  Students  will  become  familiar  with  all  aspects  of  blood  collection  and  develop  comprehensive  skills  to  perform   venipunctures  competently  and  safely.  Classroom  work  includes  terminology;  anatomy;  physiology;  blood  collection  procedures;   specimen  hands-­‐on  practice;  and,  clinical  training  in  skills  and  techniques  to  perform  puncture  methods.  The  program  also  includes   lab  exercises.  Students  will  work  with  a  training  arm  and  other  exercises  intended  to  prepare  them  to  function  as  entry-­‐level   phlebotomy  technicians.  The  curriculum  is  designed  to  provide  the  educational  information  and  competencies  required  by  the   National  Center  for  Competency  Testing,  NCCT,  for  certification  as  a  Phlebotomy  Technician.      

Note:    For  students  enrolled  in  the  Patient  Care  Technician  Program,  the  Phlebotomy  Technician  Certification  course  is  considered   Part  One,  Patient  Care  Technician.    

Your  registration  packet  includes  the  following:  

1.    Phlebotomy  Technician  Certification  Program  and  Patient  Care  Technician,  Part  One  Registration  Packet  Cover  Sheet   2.    Phlebotomy  Technician  Certification  Program  Requirements  Sheet   3.    Drug  Screens  and  Criminal  Background  Check  Sheet   4.    Phlebotomy  Technician  Certification  Program  and  Patient  Care  Technician,  Part  One  Student  Checklist   5.    Brookhaven  College  Continuing  Education-­‐Immunization  Record  Form   6.    Dallas  County  Community  College  District,  Workforce  and  Continuing  Education  Registration  Form  

Helpful  Information    

Step  1  –  Please  take  your  immunization  records  to  our  Health  Center  located  inside  the  Student  Services  Center,  Building  S,  Room   S072.The  Brookhaven  College  nurse  MUST  complete  the  Immunization  Record  form  before  you  can  register  for  this  program.    If  you   are  missing  any  immunizations,  ask  the  nurse  for  a  list  of  shots  with  which  she  can  assist  you.    TITER  tests  can  be  taken  to  confirm   that  you  have  the  required  immunizations.    The  Brookhaven  College  Health  Center  offers  two  different  Hepatitis  series.    The  most   common  one  requiring  up  to  six  months  to  complete  or  the  TWINRIX  series  that  can  be  completed  within  21  days.    

Step  2  –  Once  the  Immunization  Record  has  been  completed  and  signed,  take  all  required  documentation  (see  student  checklist)  to   the  Health  Careers  Office  located  in  Building  W,  Room  W109.    The  office  hours  are  9  a.m.-­‐6  p.m.,  Monday-­‐Thursday  and     9  a.m.-­‐4  p.m.  on  Friday.  No  appointment  is  necessary.    A  representative  will  review  and  approve  your  documentation.    You  will   receive  a  completed  Registration  Permission  Slip.    

Step  3  –  Take  the  Registration  Permission  Slip  and  DCCCD,  Continuing/Workforce  Education  Registration  Form  to  the  Admissions   Office  located  in  Building  S,  to  register  for  your  classes.    

Step  4  –  Take  your  receipt  to  the  Cashier’s  window  to  pay  for  your  courses.    Payment  is  due  at  the  time  of  registration.    

Note:   • • • • •

Liability  Insurance  MUST  be  paid  at  the  time  of  registration.   Students  MUST  provide  their  own  persona  health  insurance  coverage  prior  to  registration  that  covers  the  dates  the  class  is   in  session.   Criminal  Background  Check  and  Drug  Screens  –  required  to  be  completed  no  more  than  30  days  before  the  start  of  the   clinical  experience.   Driver’s  license,  Passport  or  State/Military  issued  ID  card  is  required.  (You  will  be  required  to  present  one  of  these  forms  of   ID  at  the  time  you  take  the  NCCT  Phlebotomy  Technician  Exam.)   Some  classes  meet  at  Texas  Health  Resources  University  located  at  8194  Walnut  Hill  Lane,  Dallas,  TX.  

  For  additional  information  about  the  Phlebotomy  Technician  Certification  Program  or     Patient  Care  Technician,  Part  One  please  call  Susana  Ruelas  at  972-­‐860-­‐7846.  

 

 

Phlebotomy  Technician  Certification  Program     and   Patient  Care  Technician,  Part  One  

   

REQUIREMENTS   Phlebotomy  Technician  Certification  Program        

Phlebotomy  Technician  Certification                                    (PLAB-­‐1023)                                                                96  hours    

Total  

                                                                             

 

 

 

                                                   96  hours  

 

Course  prerequisites  MUST  be  completed  prior  to  registration.        

Upon  successful  completion  of  this  program,  the  student  is  eligible  to  take  the  National  Center  for  Competency  Testing,  NCCT,   certification  exam  for  Phlebotomy  Technician.    

Phlebotomy  Technician  Certification  Program  Prerequisites/Requirements   Registration  must  be  done  in  person.   • High  School  Diploma  or  equivalent   • Brookhaven  College  Continuing  Education-­‐Immunization  Record  Form  

Brookhaven  College  will  require  a  copy  of  proof  of  immunization.    Immunizations  must  be  current.  The  Immunization  Record  must  be   completed  and  signed  ONLY  by  Brookhaven  College’s  Health  Center  nurse.  The  student  must  provide  proof  of  immunization  and  complete   a  Brookhaven  College  Continuing  Education-­‐Immunization  Record  Form.    The  following  immunizations  are  required:    Measles,  Mumps,   Rubella  (MMR),  Varicella,  TD  or  TDAP,  all  3  doses  of  the  Hepatitis  B  series,  Flu  Shot,  and  a  current  TB  test  (within  the  last  year).    If  students   have  had  a  previous  positive  PPD  test,  documentation  or  history  of  treatment  is  required.  

• • • •

•

A  copy  of  current  completion  card  of  Basic  Cardiac  Life  Support,  BCLS,  for  Health  Care  Providers   A  copy  of  personal  healthcare  insurance  coverage,  which  will  cover  the  dates  classes  meet   A  copy  of  valid  U.S.  or  Texas  State  Government  Issued  Photo  I.D.  (e.g.  driver’s  license)   Pass  a  criminal  background  check  and  drug  screens*   (Students  accepted  into  the  Brookhaven  College  Workforce  and  Continuing  Education  Health  Programs  are  required  by  the   Dallas-­‐Fort  Worth  Hospital  Council  Member  Facilities  to  undergo  a  criminal  background  check  and  drug  screening  prior  to   beginning  their  clinical  experience.    These  checks  must  be  completed  no  more  than  30  days  before  the  start  of  the  clinical   experience.)   *  Students  who  do  not  pass  these  two  requirements  will  not  be  allowed  to  continue  on  to  clinicals.   Dallas  County  Community  College  District,  Continuing  /Workforce  Education  Registration  Form    

The  following  are  not  included  in  the  cost  of  the  Phlebotomy  Technician  Certification  Program  and  are  the  responsibility  of  the   student.    

                   

• • • • • •

Textbooks   National  Center  for  Competency  Testing,  NCCT,  certification  exam  for  Phlebotomy  Technician   Liability  insurance  (MUST  be  paid  at  the  time  of  registration)   Personal  healthcare  insurance  coverage   Drug  Screens  and  Criminal  Background  check   Uniform  scrubs  (any  color  and  style)  

Phlebotomy  Technician  Certification  Program     and     Patient  Care  Technician,  Part  One  Program     DRUG  SCREENS  AND     CRIMINAL  BACKGROUND  CHECK     Drug  Screens   The  Brookhaven  College  WCE  and/or  a  clinical  agency  reserve  the  right  to  remove  a  student  from  the  classroom  or  clinical  facility  for   suspicion  of  drug  or  alcohol  use  and  to  submit  to  a  drug  and  alcohol  screen  at  the  student’s  expense.    Additionally,  the  college   and/or  clinical  agency  reserve  the  right  to  request  that  a  student  submit  to  a  drug  and  alcohol  screen  at  random  at  the  student’s   expense.    Students  with  a  positive  drug  screen  without  an  authorized  provider  prescription  or  a  positive  alcohol  screen  will  be   removed  from  Brookhaven  College  WCE  Health  Program.     Failure  to  comply  with  a  drug  screen  request  form  Brookhaven  or  one  of  its  clinical  agencies  will  result  in  the  student’s  immediate   expulsion  from  the  Brookhaven  College.     Furthermore,  regardless  of  testing  or  testing  results,  clinical  agencies  reserve  the  right  to  expel  students  from  their  facilities.     The  drug  screen  follows  National  Institute  on  Drug  Abuse  guidelines  and  screens  for  10  substances,  as  designated  in  the  Substance   Abuse  Panel  10,  “SAP  10.”  These  substances  are:    amphetamines,  barbiturates,  benzodiazepines,  cocaine  metabolites,  alcohol,   marijuana  metabolites,  methadone,  opiates,  phencyclidine  and  propoxyphene.     SAP  10  test  results  that  fall  outside  of  any  of  the  acceptable  ranges  are  considered  positive  test  results  and  are  automatically  sent  for   a  separate  confirmatory  test  by  a  gas  chromatography  mass  spectrometry  method.    If  these  results  are  positive,  the  test  results  are   sent  to  a  medical  review  officer  who  will  review  the  results  at  an  additional  cost  to  the  student.    The  medical  review  officer  will  then   contact  the  student  to  determine  if  there  is  a  valid  prescription  for  the  drug  in  question.    If  a  valid  prescription  exists  and  is  verified,   the  test  result  will  be  deemed  negative  and  acceptable.     An  individual  with  a  positive  drug  screen  will  not  be  allowed  to  enroll  in  any  health  related  continuing  education  courses  for  a   minimum  of  12  months  according  to  the  Community  Standard.    Prior  to  enrolling  or  returning  to  the  clinical  agency/rotation,  a   student  must  provide  proof  of  a  negative  drug  screen  as  verified  by  the  college/school.     Failure  to  comply  with  this  policy  will  result  in  disciplinary  action  and  dismissal  from  Brookhaven  College.       Criminal  Background  Check     The  criminal-­‐background  check  reviews  a  person’s  criminal  history  at  least  seven  years  prior  to  the  date  of  program  application.    The   check  will  include  all  cities  and  counties  of  the  person’s  residency  during  that  time  period.    The  following  histories  will  disqualify  an   individual  from  consideration  for  a  clinical  rotation:     • felony  convictions;     • misdemeanor  convictions  or  felony  deferred  adjudications  involving  crimes  against  persons,  e.g.  physical  or  sexual  abuse;     • misdemeanor  convictions  related  to  moral  turpitude,  e.g.  prostitution,  public  lewdness/exposure,  etc.;     • felony  deferred  adjudications  for  the  sale,  possession,  distribution,  or  transfer  of  narcotics  or  controlled  substances;  or     • status  as  a  registered  sex  offender.      

 

 

Phlebotomy  Technician  Certification  Program     and     Patient  Care  Technician,  Part  One  Program    

                                                                                                                                                               STUDENT  CHECKLIST  

  All  forms  in  this  packet  must  be  completed  and  approved  prior  to  registration.       Last  Name__________________________________  First  Name  ____________________________________     Course  and  Section  Number  ___________________________                Semester___________________________     Please  bring  the  following  documentation  to  the  Brookhaven  College  Workforce  and  Continuing  Education   Health  Careers  Office.  The  Health  Careers  Office  is  located  in  Building  W,  Room  W109.       Business  hours  are,  Monday  –  Thursday,  9  a.m.  -­‐  6  p.m.  and  Friday,  9  a.m.  –  4  p.m.   No  appointment  is  necessary.     0    Copy  of  your  High  School  Diploma  or  equivalent     0    Brookhaven  College  Continuing  Education-­‐Immunization  Record  Form     0    A  copy  of  current  Basic  Cardiac  Life  Support,  BCLS,  for  Health  Care  Providers  completion  card     0    A  copy  of  current  personal  healthcare  insurance  coverage  covering  the  dates  classes  will  meet     0    A  copy  of  valid  U.S.  or  Texas  State  Government  Issued  Photo  I.D.  (e.g.  driver’s  license)     0    Dallas  County  Community  College  District,  Continuing  /Workforce  Education  Registration  Form    

                      For  WCE  Health  Careers  Office  Use  Only:       Registration  Permission  Slip  approved  by:     _______________________________________________                              Date:  _______________                      Time:  ________________                                                                                          (Signature)                                                          

 

   

Brookhaven College Continuing Education - Immunization Record Last Name

First Name

Date of Birth

Sex:

M

F

Middle Initial

Student ID #

Program __________________

*Please have the BHC Center Nurse/ Physician / Nurse Practitioner initial form.

MEASLES (Rubeola)

HEPATITIS B / Twinrix (Hep A/B)

Select option 1 or 2 and provide requested documentation. 1.

Dates of immunization: Two (2) are required. A. First immunization with live attenuated virus. (Given after 1957 and given on or after student’s first birthday). B. Second dose separated by 28 days or more.

Date of immunization: /

/

(

)*

2. Date of blood titer: AND Quantitative result #:

/ /

/

(

/

)*OR

(

1. Date of immunization:

/

/

(

)*

2. Date of immunization:

/

/

(

)*

3. Date of immunization:

/

/

(

)*

4. Date of blood titer:

)*

)* AND

VARICELLA

Dates of immunization: Two (2) are required. a. First immunization with live attenuated virus. (Given after 1957 and given on or after student’s first birthday).

Date of immunization: / / ( )*

/ /

/

/

( (

)*OR )*

1. 2 Doses (30 days apart or more) /

/

(

)*

2. Date of blood titer: AND Quantitative result #:

/ /

/ /

( (

)* )*

*TITER OR VACCINATION REQUIRED FOR NURSING/ RADIOLOGY/ EMS

RUBELLA (German Measles)

TB

Select option 1 or 2 and provide requested documentation. 1.

(

*** TITER REQUIRED FOR PARAMEDIC***

Select option 1 or 2 and provide requested documentation.

2. Date of blood titer: Quantitative result #:

/

Quantitative result #

MUMPS 1.

/

First immunization with live attenuated virus. (Given after 1957 and given on or after student’s first birthday).

PPD

Date:

Result :

/

Negative

/

(

Positive

)* mm. (

)*

Date of immunization: /

/

(

/

)*

2. Date of blood titer: Quantitative result #:

/

/ /

( (

)*

Chest X Ray Date: Result :

MMR 1. Date of immunization:

/

/

(

)*

2. Date of immunization:

/

/

(

)*

FLU VACCINATION 1. Seasonal Flu Shot:

/

OR

)*OR

/

Negative

/

/

(

Positive (

)*

)*

***WITHIN THE LAST YEAR AND YEARLY THEREAFTER***

Tdap/ tetanus, diphtheria and acellular pertussis (Within 10 years for ALL students).

(

)*

1. Date of immunization:

/

/

(

)*

BHC Center Nurse/ Physician / Nurse Practitioner Signature SIGNATURE:

DATE: UPDATED 12/03/2014

Continuing/Workforce Education Registration Educational opportunities are offered by the Dallas County Community College District without regard to race, color, age, national origin, religion, sex, disability or sexual orientation.

Please check the college you plan to attend. Brookhaven College

Cedar Valley College

Eastfield College

El Centro College (ECC)

3939 Valley View Lane Farmers Branch, TX 75244-4997 972-860-4600

3030 North Dallas Avenue Lancaster, TX 75134-3799 972-860-8210 fax 972-860-8033

3737 Motley Drive Mesquite, TX 75150-2099 972-860-7113 fax 972-860-8306

Main & Lamar Streets Dallas, TX 75202-3604 214-860-2147 fax 214-860-2124

Mountain View College

North Lake College

Richland College

ECC-Bill J. Priest Campus

4849 West Illinois Avenue Dallas, TX 75211-6599 214-860-8835 fax 214-860-8570

5001 N. MacArthur Blvd. Irving, TX 75038-3899 972-273-3360 fax 972-273-3378

12800 Abrams Road Dallas, TX 75243-2199 972-238-6144 fax 972-238-6149

1402 Corinth Street Dallas, TX 75215-2111 214-860-5700 fax 214-860-5870

Dallas TeleCollege 9596 Walnut Street Dallas, TX 75243-2112 972-669-6400 fax 972-669-6409

Student Information

Please print.

* Please check appropriate box; your responses to these questions are voluntary - information is used to meet Texas State reporting requirements only.

New Student Existing Student

* Male * Female

*Social Security Number: _______-______-________ DCCCD Student I.D. Number: ___________________

Ethnicity information is used to meet Texas State reporting requirements and providing this information is voluntary on your part.

White, Non-Hispanic Black, Non-Hispanic

Hispanic Asian/Pacific Islander

Last Name

American Indian/Alaskan Native International/Non-Immigrant

First Name

Other No Response

MI

Address City

State

Zip

Home Phone

Work Phone

County

Country

Cell Phone

Fax

E-mail Address _____________________________ I verify that the above information is accurate.

Date of Birth ____________________

Signature________________________________________

Date_____________

Course Information (Certain Continuing Education courses have entrance requirements that student must meet prior to registration. Consult college for details.) REG #

TERM

COURSE #

SECTION #

COURSE TITLE

DAYS

DATES

TIME

LOCATION

FEE

Payment Information You are able to pay by credit card on the web if you have previously registered and provided your e-mail address. If paying by check, include Driver’s License Number and State on the top of the check, not on this form. Refund Policy: A refund of 100 percent will be made if requested prior to the first scheduled meeting day. Your request for a refund must be made during business hours prior to the first day of class to qualify for a 100 percent refund. A refund of 80 percent is allowed before the close of business on the day of the second class meeting. No refund is allowed after the second class meeting. Should the college cancel the class a 100 percent refund will be issued. Refunds may take up to four weeks to process. The Colleges of the Dallas County Community College District reserve the right to make changes that may include, but are not limited to, the days and times courses are offered, classroom location, instructors who teach the course, and cancellation of courses. Third Attempt to Enroll in a Course: Effective for Fall Semester 2005, the Dallas County Community Colleges will charge a higher tuition rate to students registering the third or subsequent time for a course. All third and subsequent attempts of the majority of credit and Continuing Education/Workforce Training courses will result in higher tuition to be charged. Developmental Studies and some other courses will not be charged a higher tuition rate. Third attempts include courses taken at any of the Dallas County Community Colleges since the Fall 2002 semester. FORM NO. 0817-08/06