Get Pima Community College Health Declaration/physical Examination Form - Mlt Program

Completing the Pima Community College Health Declaration/Physical Examination Form for the MLT Program is essential for all student applicants. This guide will provide you with detailed instructions on how to fill out this important document online, ensuring you meet all necessary requirements.

Follow the steps to successfully complete the health declaration and physical examination form.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling in the Student Applicant Contact Information section. Provide your full name, PCC I.D. number, street address, city, state, ZIP code, home phone, work phone, cell phone, and email address.
3. Review the Health Declaration section carefully. This section will indicate that medical laboratory technician students must meet the Technical Standards Essential for MLT Practice, which will be evaluated during the physical examination.
4. Proceed to the Physical Examination section. A licensed health care provider, such as an MD, DO, NP, or PA, must assess whether you are capable of meeting the Technical Standards Essential for MLT Practice.
5. In the Exposure and Hazards section, review the information about the risks associated with working in medical laboratory environments. This includes exposure to harmful substances, so understanding this is crucial.
6. Complete the Technical Standards Essential for MLT Practice section. Your health care provider will evaluate your ability in various functional skills required for the program.
7. Make sure your health care provider answers the required questions regarding your health and ability to perform the necessary standards. They must indicate whether you can safely deliver client care and if you can perform the technical standards.
8. Once finished, the licensed health care provider should sign the form and provide their information on the designated page.
9. The Clinical Eligibility Requirements section outlines the immunizations and tests needed. Ensure you acquire electronic copies of all required documents and immunization records to submit along with the form.
10. After confirming all the necessary fields are filled out and documents are acquired, save changes to the form, then download, print, or share it as needed.

Complete your health declaration and physical examination form online today to ensure your readiness for the MLT program.