ATTENTION: College offices closed for business through Jan. 1. More.
Maintenance outages this weekend.
Health Records
Many health programs require you to fill out a health record before you can enroll in the program. These health records disclose health history, immunizations and information of that nature.
They are collated by the Health Records Office.
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Office Information |
Health Records Office |
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Hours of Operation |
Monday-Friday, 8:00 a.m. - 4:30 p.m. |
Most of these forms are in the Adobe Acrobat format and require a browser plug-in to view. Download Adobe pdf reader.
For detailed information on health record requirements, please read the Health Record Fact Sheet.
Health Record Submission Deadlines
Completed Health records MUST be submitted NO LATER THAN THE DATE LISTED BELOW TO REGISTER ON THE "FIRST DAY" OF REGISTRATION:
**Health records can be turned in after this date up until the start of the semester. Please allow 5 business days for processing.
| Spring 2014 | October 11, 2013 |
| Summer 2014 | February 10, 2014 |
| Autumn 2014 | April 4, 2014 |
Health Record Forms by Program
Clinical Laboratory Assisting (CLA)
Dental Hygiene
EKG
EMS Paramedic
EMT and Firefighter
Medical Assisting
Medical Laboratory
NURC 1101 Nurse Aide Training Program (This course is a prerequisite for the following programs: Nursing, Practical Nursing,
Respiratory, Sterile Processing and Surgical Technology)
Nuclear Medicine
Nursing (Pre-Nursing students should fill out the NURC 1101 record)
Phlebotomy
Practical Nursing (Pre-Nursing students should fill out the NURC 1101 record)
Radiography
Respiratory (Pre-Respiratory students should fill out the NURC 1101 record)
Sterile Processing (Pre-SPT students should fill out the NURC 1101 record)
Surgical Technology (Pre-Surg Tech students should fill out the NURC 1101 record)
Miscellaneous Forms
Annual Health Evaluation
Health History Form
Insurance Form-Veterinary
Latex Reaction Form
Medical Release
Needle Stick Report
Physical Exam Form
Physician Certification Form
Supplementary Immunization Record
TB Test (Single Step)
TB Test (Two Step)
