Get Application For Phlebotomy Technician Certification - Cuesta - Academic Cuesta

This guide provides clear and detailed instructions on filling out the Application For Phlebotomy Technician Certification - Cuesta - Academic Cuesta online. Following these steps will help you complete the application accurately and efficiently.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the application form and open it in the editing interface.
2. Carefully read the instructions provided on the application form. Note that an application fee of $54.00 is required along with two passport-sized photos.
3. Complete personal information fields: Include your first name, middle initial, last name, mailing address, city, county, state, ZIP code, birth date, telephone number, email address (if applicable), and Social Security Number.
4. Select your gender, and if applicable, provide your maiden name or previous last name.
5. Indicate whether you have applied for this or a similar certification before, and if yes, include any relevant details.
6. Answer questions regarding prior California personnel certificates or licenses, including type and number.
7. Disclose any felony or misdemeanor convictions and provide a statement if necessary.
8. Confirm that you have requested official transcripts to be sent directly from your school's registrar to the specified address.
9. Complete the education section by indicating the names of schools, dates attended, and units completed.
10. Fill in details for didactic instruction and practical instruction in phlebotomy, including the name and address of training programs, dates, and hours attended.
11. Outline your on-the-job experience in phlebotomy, listing your employers, work hours, estimated successful punctures, and addresses.
12. Attach a copy of any certificates of successful completion from national certifying organizations and provide the relevant examination details.
13. Read and understand the declaration of truth statement, then sign and date the application using blue ink.
14. Prepare and mail your fully completed application, along with payment and required documents, to the specified address.

Complete and submit your Application For Phlebotomy Technician Certification online today.