Tuesday, 07 February 2012
2008 Kick-off Gallery
Home
Students
Schools
Appleton West
Appleton North
Appleton East
Kimberly
Fox Valley Lutheran
Xavier
Kaukauna
St. Mary Central
Little Chute
Freedom
Hortonville
Other
Job Shadowing
Parents/Guardians
Providers
Forms
Health Requirements
Confidentiality Agreement
Bloodborne Pathogens
BBP Quiz
Program Evaluation
Reference Form
Contact
Courtney Vosters, RN, BSN
Medical Mentoring Coordinator
courtney.vosters@osifv.com
(920)277-1722 (cell)
(920)968-2233 (fax)
2105 E. Enterprise
Appleton, WI 54913
Home
Students
Schools
Xavier
Requirements for Application:
Must complete a career day through
Fox Valley Healthcare Alliance
before April or have completed a career day in the past
Be interested in a health career
Currently a member of the junior class (interested sophmores speak with your contact teacher)
Agree to uphold ethical and confidentiality standards
Commit to 12 hours within specific week assigned
Submit application online AND turn in one recommendation letter to Mrs. Schuh by Feb 24th
Course Pre-requisites:
Chemistry/Honors Chemistry or
Biology/AP Biology
Requirements once Accepted:
Complete Blood Borne Pathogens Training and quiz ONLINE
Turn in a copy of your immunization record
Have a current TB test on record
Complete HIPPA training with Mrs. Schuh
Turn in signed Confidentiality Agreement
Attend kick-off meeting with a parent or guardian
Complete and turn in Evaluation form after completion of your shadowing experience
Attend Graduation Celebration
I have read and agree to meet all of the requirements.
Powered By ChronoForms - ChronoEngine.com