Merced College Diagnostic Medical Sonography Program Admission Policies, Procedures & Application Forms Revised: September 2017 T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 1 December 7, 2017
Merced College Diagnostic Medical Sonography Program Admission Policies & Procedures Submit your COMPLETED application packet to the Allied Health Office IN PERSON ONLY. Mailed, faxed or emailed applications will NOT be accepted! Upon submission of a completed application, the date and time received will be stamped on the application. After your records have been verified, that date and time will become your official application date. You will receive a notice in the mail advising you of the following: you meet the Entrance Requirements and Prerequisites your official application date & time, and your number on the enrollment list If you do not meet all the application requirements, your application will be returned nullifying any application receipt date. Enrollment will be based on a first come, first serve basis with the first eight to ten QUALIFYING applicants allowed to enroll for the class beginning August 2018. T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 2 December 7, 2017
Merced College Diagnostic Medical Sonography Program Program Costs Legal residents of the State of California are required to pay nominal fees. In addition, students may expect other miscellaneous fees and expenses during the length of the program. (Non Resident tuition fee: $173 per unit, plus enrollment fee) Fees Enrollment/Tuition Fee (entire program 49 units x $46/unit) $2,254 Contact admissions and records for details. Fees subject to change as per the State Legislature Health Fee (entire program) $79 Parking ($20 x 4 semesters; $10 x 1 summer) $90 Additional Expenses CPR Certification $60 Physical & Immunizations $300 Uniforms $180 Lab Supplies $75 Books (entire program) $1,700 Background Clearance & Drug Screening $90 Trajecsys ($100/year x 2 years) $200 Licensing ARDMS (Physics) $225 ARDMS (Obstetrics/Gynecology) $250 ARDMS (Abdomen) $250 Fees are subject to change at anytime Total $5,753 T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 3 December 7, 2017
Merced College Diagnostic Medical Sonography Program Name: Student ID #: Read all information contained in the information packet carefully before submitting application. Submit application and all pertinent documents to the Allied Health Office (room 126). Incomplete files will be returned to the applicant. *New and Returning Students will be required to apply for college admission and complete appropriate registration procedures, and obtain a Student I.D. number and card. Further Registration information is available online: www.mccd.edu (click on the Admission & Aid button on the home page, then select How to Apply ) Check Off Sheet Application to the SONO Program MUST include the following (if applicable) in this order: Check Off Sheet (this form) Application Copy of your professional license or Official Sealed Transcript verifying your Bachelor s Degree Unofficial Transcript from Merced College Transcript must be printed from the Admissions & Records Office No Exceptions if applicable Official Transcript(s) from other colleges if applicable Prerequisite Course Form In Process Prerequisite Course Form if applicable Transcript Request Form Understanding of Program Regulations Form Hospital based Patient Care Experience Forms if applicable Enrollment List/Status Report Self Addressed Stamped Envelope T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 4 December 7, 2017
Merced College Allied Health Division Diagnostic Medical Sonography Program Application Date: For Office Use ONLY Complete Application received on: Time: Print Clearly Initials: GPA Last Name First Name M.I. Former (Maiden, Other) Mailing Address City State Zip Date of Birth Soc. Sec. No or ITIN (Individual Taxpayer Identification No.) MC Student ID No. Telephone #(s) Gender G Female G Male Ethnicity Entrance Requirement (check one) Radiologic Technology (Attach Current license) Nuclear Medicine (Attach Current license) Registered Nursing (Attach Current license) Respiratory Therapy (Attach Current license) Bachelor s Degree (attach sealed official transcript verifying your degree) Completion of Prerequisite Courses All program prerequisites must be passed with a grade of C or better and combined GPA of 2.35 or higher ALLH 67 Medical Terminology BIOL 16 General Human Anatomy BIOL 18 Principles of Physiology ENGL 1A College Composition & Reading or COMM 1 Fundamentals of Speech MATH 10 or MATH 15 or MATH 25 or MATH 26 ONLY PHYS 10 Concepts in Physics or *RADT 13 Radiologic Sciences (*course is only offered in the Merced College Diagnostic Radiologic Technology Program I certify that all information provided in connection with this application is true, correct and complete. Providing false information or omitting required information is fraud and grounds for denial of enrollment or immediate expulsion from the Diagnostic Medical Sonography Program. Signature Date T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 5 December 7, 2017
Attn: All students must submit this form Prerequisite Course Form COUNSELOR SIGNATURE REQUIRED ONLY if your prerequisites have been completed at another school/university. All program prerequisites must be passed with a grade of C or better and combined GPA of 2.35 or higher. Name: Student ID #: Prerequisite College/University Course Name & Number Grade Unit Value Semester & year Counselor Signature verifying equivalency ALLH 67 Medical Terminology BIOL 16 General Human Anatomy BIOL 18 Principles of Physiology ENGL 1A College Composition & Reading or COMM 1 Fundamentals of Speech MATH 10 or MATH 15 or MATH 25 or MATH 26 ONLY PHYS 10 Concepts in Physics or *RADT 13 Radiologic Sciences (*course is only offered in the Merced College Diagnostic Radiologic Technology Program Merced College Allied Health Counselor Print Name Signature Date T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 6 December 7, 2017
Diagnostic Medical Sonography Program In Process Prerequisite Course Form Name: Student ID #: I, am currently enrolled in the following Program Prerequisite Course(s) this semester, Spring 2018. Upon completion of the semester, I will provide a transcript verifying completion of the course with a C or better. I am also responsible to ensure equivalency of my course(s). I understand that if I fail the course(s) listed below, my application becomes null and void. Prerequisite College/University Course Name & Number Unofficial Grade Unit Value Signature of Professor(s), Date & attach business card ALLH 67 Medical Terminology BIOL 16 General Human Anatomy BIOL 18 Principles of Physiology ENGL 1A College Composition & Reading or COMM 1 Fundamentals of Speech MATH 10 or MATH 15 or MATH 25 or MATH 26 ONLY PHYS 10 Concepts in Physics or *RADT 13 Radiologic Sciences (*course is only offered in the Merced College Diagnostic Radiologic Technology Program Attach Business Card(s) T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 7 December 7, 2017
Transcript Request Attn: All students must submit this form Last Name First Name Middle Name Former Names (Maiden, Other) Social Security No. MC Student ID No. Did you attend Merced College before 1986? 9 Yes 9 No Signature Date T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 8 December 7, 2017
Understanding of Program Regulations Name Student ID #: I understand Merced College reserves the right to revise enrollment requirements, Program Prerequisites and/or Selection Procedures at ANYTIME. I understand it is my responsibility to meet enrollment requirements, program prerequisites, ensure equivalency, follow proper application procedures, provide transcripts and keep informed on revisions regarding the program. I understand that if I submit an application packet that is incomplete, or does not meet enrollment requirements, program prerequisites/application requirements, it will be returned to me with an explanation of why it was returned and the date of submission of my application becomes null and void. I understand that after my application is accepted and verified, it is my responsibility to notify the Allied Health Office of any changes in address and/or telephone number. I understand that if I am admitted into the program, failure to notify the Allied Health Office with a "Confirmation of Acceptance" in the allotted time prescribed constitutes grounds to assign my position to an alternate. I understand that if I am admitted into the program and I must decline acceptance, my slot will go to the next student on the enrollment list. I understand that if I withdraw or am dismissed from the program, I will no longer be eligible for readmittance into the program. Signature Date Authorized Allied Health Office Personnel s Signature Date T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 9 December 7, 2017
Diagnostic Medical Sonography Program Hospital based Patient Care Experience Submit for each hospital location Name of Prospective Student: Name of Hospital: Address of Hospital: Direct Phone # of Supervisor: Month(s) &Year(s) of Service: From: To: Evaluation of Student on next page º T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 10 December 7, 2017
Diagnostic Medical Sonography Program Hospital based Patient Care Experience Submit for each hospital location Supervisor Only sign and evaluate student if he/she has completed 500 hours or more of Hospital based Patience Care Experience (paid and/or volunteer experience is acceptable) Evaluation of Student Supervisor place an X in the box which best describes the performance of Employee and/or Volunteer Exceptional Satisfactory Needs Improvement Hospital bed and wheelchair patient transportation; ability to safely transfer patients on/off scanning tables; application of personal body mechanics Discuss the use, and care for intravenous lines, catheters, percutaneous drains, ET tubes, and oxygen administration devices Maintain infection control and utilize standard (universal) precautions; bloodborne pathogen protection; ability to properly manage bodily fluids; management, and proper disposal of contaminated and biohazard materials; proper hand washing techniques; isolation precautions Discuss appropriate responses to condition specific medical emergencies; request assistance with life threatening situations Ability to effectively communicate (oral, written and non verbal) with all hospital stakeholders Knowledge of Medical Imaging Department ALARA principles; shadow in the Imaging / Sonography Department(s) Working knowledge of patient confidentiality/ HIPAA; patient identification procedures Ability to perform blood pressure Comments (you may attach a separate sheet if necessary): Supervisor s Name: Supervisor s Signature: Date: Attach Business Card T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 11 December 7, 2017
Diagnostic Medical Sonography Program Enrollment List/Status Report Name: Student ID #: Your application, transcripts and supporting documentation have been reviewed and verified. You are therefore qualified to be on the Enrollment List for the class beginning August 2018. As of this date: Your number on the Enrollment List is: Your official application date & time is: Your GPA is: Enrollment will be based on a first come, first serve basis with the first eight to ten QUALIFYING students allowed to enroll. You will be notified in 3 4 weeks of your acceptance into the program. Notify this office as soon as possible if you have changed your plans and no longer wish to remain eligible for entry into the program. If you have any questions contact the Allied Health Office at 209.384.6309 or 209.384.6123. T:\Sonography\Sono Application & Acceptance Letters\General Application\SONO Application 2018.wpd 12 December 7, 2017