Medical Assistant Waitlist Process

Medical Assistant Waitlist Process
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
BTECH Student ID
Please list your first preferred start month:
Please list your second preferred start month:
I would like:

Full Time (25 or 30 hours per week)Part Time (20 hours per week)
The "Submit" button, which is located on the last page, will save your uploads and send you a link that will allow you to edit and continue to update until all parts are complete.

PRE-ADMISSION CHECKLIST
Immunization Verification
- Tdap (tetanus, diphtheria, and pertussis) ( current within 10 years)
- MMR (measles, mumps, rubella) (2 series injection or Blood Titer)
- Varicella shot - (2 series injection or Blood Titer)
- Hepatitis B Blood Titer
- Flu Vaccination - Proof of current influenza vaccination from October 31 through March 30
In accordance with the Centers for Disease Control Prevention (CDC) and in an effort to minimize risk to students and staff, each student must have documentation of current immunizations/vaccinations before acceptance into the certificate program. Immunizations/vaccinations may be documented with an immunization record or blood titer.
Upload Immunization Verification

Cancelof
Tuberculosis Test (TB Test)

The TB test is performed by your doctor or local health department. It is a two-shot series to evaluate exposure to Tuberculosis. It must be current within 12 months, or you can run a blood titer, Quantiferon Gold test.
Upload Tuberculosis Test

Cancelof
Covid-19 vaccination

This vaccination is recommended but not required.
The "Submit" button, which is located on the last page, will save your uploads and send you a link that will allow you to edit and continue to update until all parts are complete.
Should be Empty:

PRE-ADMISSION CHECKLIST