INSTRUCTIONS FOR APPLYING TO
THE PHOENIX COLLEGE MEDICAL ASSISTING PROGRAM
This is your application packet for the Phoenix College Medical Assisting Program. Please read all of the
information in this packet completely and follow the instructions carefully. The applicant is responsible for
making certain that the application and all required documentation are complete. If NOT complete, the
application will be denied. Follow the checklist on page 17 carefully; this will help you make sure that your
application is complete. Incomplete applications will certainly delay processing the application and, as noted
above, incomplete applications will result in denial of admission.
Step 1:
Step 2:
Step 3:
Step 4:
Step 5:
Read ALL the material in this packet including the program description, essential skills and
functions, requirements for admission, steps for applying, etc, VERY CAREFULLY. Complete all
required application forms as instructed as you go through the packet.
Obtain or complete all the requirements described on page 17 of this packet.
All of this information MUST be included with the application packet when application is
submitted. You must include copies of your immunization records along with your Health
and Safety Documentation form or your application will be denied on the basis of it being
incomplete.
You must provide transcript evidence of coursework completed as follows:
HCC145 – Medical Terminology for Healthcare Workers – grade of A or B
HCC130 – Fundamentals of Healthcare – grade of A or B
ENG101 and/or ENG102 – First Year Composition – grade of A or B
CRE101 – College Critical Reading – grade of A or B
MAT091 or MAT092 – Introductory Algebra – grade of A or B
If you have not taken ENG101/102, CRE101, and/or MAT091/092, you may go to the Testing
Center at Phoenix College (or any of the other Maricopa County Community Colleges) and
take the placement tests for Writing/Sentence Skills, Reading Skills, and Elementary Algebra
Skills and include copies of those results with your application packet. Placement test results
must be as follows:
READING: All placement test scores must show “Reading Exempt.”
WRITING/SENTENCE SKILLS: Asset=50 or higher; Compass=80 or higher; Accuplacer=80 or
higher; Writeplacer=5 or higher.
ELEMENTARY ALGEBRA: Asset=41 or higher; Compass=41 or higher; Accuplacer=70 or higher.
If you have a question about the Medical Assisting Program, you may contact the Medical
Assisting Program Director at 602-285-7927. If you have a question about Phoenix College in
general, you may call the Admissions Office at 602-285-7800, the Advisement Center at 602285-7110, or Student Life at 602-285-7231.
When you are certain that you have assembled all of the required application materials and
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Included them with the application packet, and signed or initialed all the appropriate places,
please review the application packet one last time for completeness. You should then handdeliver your completed application packet (including this form) by 4:00 pm, Wednesday, May
7, 2014 to the reception desk at the Phoenix College Advisement Center.
I certify by signing below that I have completed this application and that the required documentation is
complete and attached.
______________________________________________
________________________
Signature
Date
Advisement Center: Please sign or initial this form in the box below, indicating receipt of the application
and included materials.
For Advisement Use Only:
Name:
T.D.S.
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PROGRAM INFORMATION
DESCRIPTION
The Medical Assisting Certificate Programs prepare students for entry-level medical assisting positions. The
Medical Front Office certificate is awarded to students who have completed classes that train students to
perform clerical/administrative duties in a medical practice. The Medical Assisting Certificate is awarded to
students who have completed training in both the clerical/administrative duties and the clinical functions of
medical assisting. A list of courses for both certificates is included in this packet.
In addition, an AAS (associates degree) in Medical Assisting is available to students who have completed both
certificate programs and the additional coursework required for the degree.
OCCUPATIONAL INFORMATION
Medical assistants perform routine administrative and clinical tasks in the practices of numerous health
professionals. Duties can vary but typical duties performed by medical assistants include using various
computer software applications, answering telephones, greeting and checking in patients, processing medical
records, coding and/or filing insurance forms, scheduling appointments, taking vital signs, obtaining medical
histories, preparing patients for examinations, assisting physicians with exams and/or procedures, collecting
and/or preparing laboratory specimens, performing laboratory tests, preparing and administering medications
(as directed by a physician), performing electrocardiograms, removing sutures, changing dressings, etc.
Average starting wages for entry-level medical assistants in the greater Phoenix area is $13.50 to $15.50 per
hour.
NATIONAL CERTIFICATION
Medical assistants practicing clinical skills are regulated in the state of Arizona. Completing students have a
grace period of approximately six months in which to take their national examination. The national
examination for medical assisting is available through the American Medical Technologists (AMT); successful
completion of this exam awards the RMA (registered medical assistant) credential. (Note: This exam is not
required of front office medical assistants.)
COST OF THE MEDICAL ASSISTING PROGRAM
The total cost of the Medical Assisting Program, including tuition, fees, books, supplies, and equipment is
approximately $4500. This does not include the cost of a stethoscope, watch with a sweep second hand,
closed-toed shoes, and scrubs which students are required to have for the program.
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CLASSES IN THE MEDICAL ASSISTING PROGRAM
Prerequisites: HCC145 (3 credits)
HCC130 (3 credits)
Medical Front Office:
SPA117
Healthcare Spanish I (3 credits)
MAS125
Professionalism in Healthcare (1 credit)
MAS126
Administrative Procedures (3 credits)
MAS127
Insurance, Billing, and Coding (3 credits)
MAS128
Electronic Health Records for Medical Assisting (1.5 credits)
MAS129
Automated Computer Systems for Medical Office Management (2 credits)
MAS274
Administrative Medical Assisting Externship (1 credit)
Clinical Medical Assisting (“Back Office”):
MAS130
Orientation to Physiology and Psychology of Body Systems (1 credit)
MAS210
Aseptic Techniques (1 credit)
MAS220
Laboratory Testing in Patient Care Service Centers (1 credit)
MAS230
Emergencies in the Medical Office (1.5 credits)
MAS240
Applied EKG (1 credit)
MAS260
Clinical Procedures (3 credits)
MAS265
Administration of Medication (3 credits)
PLB109
Phlebotomy Basic Skills (1 credit)
PLB110
Practicum: Fundamental Phlebotomy Skills (0.5 credit)
MAS275
Clinical Medical Assisting Externship (2 credits)
MAS280
Medical Assisting Program Review (1 credit)
HEALTH DECLARATION
All students must provide documentation of compliance with all health and safety requirements in order to
protect patient safety. Only students who are in compliance will be considered for enrollment in Medical
Assisting courses. These requirements are listed on page 17. Students prove that they meet these
requirements by providing the required documentation for all immunizations plus the Health and Safety
Declaration form signed by a licensed healthcare provider.
In addition, students must be able to fully participate in program activities, whether in the classroom, the
laboratory, or in clinical settings. Students who have a chronic illness or medical condition must maintain
current treatment and be able to participate in direct patient care. This includes the externships which may
also have additional requirements and/or restrictions for participation. Should a student become unable to
participate, partially or fully, in program activities, he/she may be withdrawn from the program.
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The Medical Assisting Program does include invasive procedures (phlebotomy and administration of injectable
medications). The performance of exposure-prone procedures includes a recognized risk of percutaneous
injury and, should such injury occur, blood is likely to contact a patient’s body cavity, subcutaneous tissues,
and /or mucous membranes. This can pose a material risk to both patients and other students in the program,
should the student have a communicable chronic illness.
Please refer to the following website for the CDC’s MMWR for recommendations for Preventing Transmission
of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure Prone Invasive
Procedures. http://www.cdc.gov/mmwr/preview/mmwrhtml/00014845.htm
The Medical Assisting Program Director reserves the right to review on a case by case basis, the ability of a
student to fully participate in and complete the program.
ESSENTIAL REQUIREMENTS FOR SUCCESS IN THE MEDICAL ASSISTING PROGRAM
1. Students must be available to attend classes full-time, 8:15 am to 5:00 pm Tuesdays, Wednesdays,
and Thursdays each week from beginning to end of program.
2. Students must be available for a clinical externship at the end of course work. This externship may
be done five days per week but no less than three days per week during regular business hours of
medical practices (i.e. 8:00 am to 5:30 pm or when patients are done being seen for the day).
3. Students must be able to keep up with payments on courses and fees so as to not be dropped from a
class that is in progress.
4. Students must be able to purchase those textbooks used in the program so as to have them when
needed for course work.
5. Students must have a support system in place which will enable them to avoid issues with childcare,
appointments, time to dedicate to studying and doing assignments, and other requirements of the
program.
ESSENTIAL SKILLS AND FUNCTIONAL ABILITIES NEEDED BY MEDICAL ASSISTING STUDENTS
It is essential that Medical Assisting students be able to perform a number of physical activities in the clinical
portion of the program. Students will be required to stand for several hours at a time and perform activities
that require bending forward and flexing the knees. The clinical medical assisting experience also places
students under considerable mental and emotional stress as they undertake responsibilities and duties
impacting patients’ lives. Students must be able to demonstrate rational and appropriate behavior under
stressful conditions. Individuals should give careful consideration to the mental and physical demands of the
program prior to making application.
Individuals enrolled in the Medical Assisting Program must also be able to perform essential skills. If a student
believes that he or she cannot meet one or more of the skill standards without accommodations, the program
director will determine, on an individual basis, whether reasonable accommodations can be made.
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Essential skills and abilities refer to those physical, cognitive and behavioral abilities required for satisfactory
completion of all aspects of the Medical Assisting Program curriculum. Also included is the development of
those personal attributes required by both the faculty and the program director of all students by the time of
program completion and prior to the externship. Students not exhibiting such attributes will not be placed in
externship.
Essential abilities in the following areas are required by the curriculum: Motor, sensory, communication,
intellectual abilities for problem-solving and assessment, and the behavioral and social characteristics of a
professional medical assistant. These are attributes every medical assistant must possess.
Motor Skills
Students must possess the physical dexterity to master technical and procedural aspects of patient care:
Lifting/ standing/sitting for long periods of time; adequate physical stamina and energy to carry out taxing
duties over long hours; providing care in confined spaces; motor skills and dexterity sufficient to handle small
equipment and instruments safely.
Sensory Abilities
Students must be able to gather information using all senses but especially sight, hearing, and touch in order
to perform the duties of a medical assistant.
Communication Skills
Students must be able to communicate effectively in English with accuracy, clarity and efficiency with patients,
their families and other members of the healthcare team including verbal (spoken) and nonverbal
communication (such as interpretation of facial expressions, affect and body language), and must be able to
work cooperatively with instructors, supervisors, fellow students, and healthcare team members. Students
must be able to accurately perform patient identification procedures.
Students must be able to communicate effectively with patients, gather information appropriately, explain
medical information and procedures in a patient-focused manner, listen effectively, recognize, acknowledge
and respond to emotions, and exhibit sensitivity to social and cultural differences.
Computer Skills
Students must possess basic computer skills. Students must understand basic computer language (i.e.
“upload,” “download,” “save” as opposed to “save as,” etc.), know how to cut-and-paste or copy-and-paste,
how to open multiple windows on the computer and maneuver back and forth between windows, how to save
files to a USB drive, how to name and rename files, and how to perform basic email functions.
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Intellectual Abilities
Students must be able to comprehend and learn factual knowledge from readings and teaching presentations,
to gather information independently, to analyze and synthesize material learned, and to apply learned
information to clinical situations. Students must be able to arrive at sound clinical judgments and
demonstrate well-integrated knowledge about the processes of patient care in medical assisting including
patient assessment, patient education, and the implementation and evaluation of medical assisting care and
services. Students must be comfortable with uncertainty and ambiguity in some clinical situations, and be
willing to seek the advice of others when appropriate.
Behavioral, Social and Professional Abilities
Students must possess the emotional maturity and stability to function effectively under the level of stress
that is inherent in healthcare professions and to adapt to circumstances which are unpredictable and/or which
change rapidly. They must be able to interact productively, cooperatively, and in a collegial manner with
individuals of differing personalities and backgrounds, and be an active contributor to the process of providing
healthcare by demonstrating the ability to engage in teamwork and team-building. Students must
demonstrate the ability to identify and set priorities in patient management and in all aspects of their
academic and professional work. They must be punctual and perform work within strict time frames.
Students must be capable of an empathetic response to individuals in various circumstances and be sensitive
to social and cultural differences. Students must exhibit an ethic of professionalism, including the ability to
place others’ needs ahead of their own. They must exhibit compassion, empathy, altruism, integrity,
responsibility and tolerance, as well as the ability to exercise the necessary level of sound judgment required
in the practice of medical assisting.
NOTE: For questions regarding any of the above information, please contact the Medical Assisting Program
Director (contact information on page 1 of this packet).
ESSENTIAL ABILITIES REQUIREMENTS FOR PROMOTION AND RETENTION SIGNATURE
I have read and have had the opportunity to have all of my questions answered regarding the Essential
Abilities Requirements for Promotion and Retention in the Phoenix College Medical Assisting Program. My
signature represents that I understand, agree with, and will abide by these requirements.
___________________________________________
Signature/Date
***NOTE: Your signature on this statement (signifying understanding of, agreement with, possession
of, and commitment to the program requirements) is mandatory for admittance into the Medical Assisting
Program. If this statement is not signed, the application will not be considered. If this statement is signed and
the student later demonstrates that they do not possess the minimum requirements described, he or she may
not be able to continue in the program.
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In addition to including academic transcripts and/or placement test results with your application, please
complete the competency tests for writing/grammar, reading, and elementary algebra as below and on the
following pages.
BASIC SENTENCE/GRAMMAR COMPREHENSION SCREENING
Please choose the best answer from the choices given for each of the following:
1. Everyone in the bank, including the manager and the tellers, ran to the door when the fire alarm rang.
a. tellers, ran
b. tellers: ran
c. tellers, had run
d. tellers-ran
e. tellers' ran"
2. To no ones surprise, Joe didn't have his homework ready.
a. no ones surprise
b. noones surprise
c. no-ones surprise
d. no ones' surprise
e. no one's surprise
3. If he would have read "The White Birds," he might have liked William Butler Yeats' poetry.
a. would have read
b. could have read
c. would of read
d. could of read
e. had read
4. After the hurricane, uprooted trees were laying all over the ground.
a. were laying
b. lying
c. were lying
d. were laid
e. was laid
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5. The recently built children's amusement park has been called "a boon to the community" by its supporters and "an
eyesore" by its harshest critics.
a. and "an eyesore" by its harshest
b. and, "an eyesore," by its harshest
c. and, an eyesore; by its harshest
d. and-an eyesore-by its' harshest
e. and-"an eyesore"-by its' harshest
6. I always have trouble remembering the meaning of these two common verbs, affect (to change" or "to influence")
and effect ("to cause" or "to accomplish)."
a. "to accomplish)."
b. "to accomplish").
c. "to accomplish).
d. To accomplish.
e. "to accomplish.")
7. My class just finished reading-"The Fall of the House of Usher", a short story by Edgar Allan Poe.
a. reading-"The Fall of the House of Usher",
b. reading, The Fall of the House of Usher,
c. reading "The Fall of the House of Usher,"
d. reading, "The Fall of the house of Usher,"
e. reading: The Fall of the House of Usher8. After it was repaired it ran perfect again.
a. ran perfect
b. ran perfectly
c. could run perfect
d. could of run perfect
e. would run perfectly
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9. "Are there two E's in beetle," asked Margo?
a. there two E's in beetle," asked Margo?
b. their two E's in beetle?" asked Margo.
c. their two E's in beetle," asked Margo.
d. there two E's in beetle?" asked Margo.
e. there two E's in beetle, asked Margo?
10. The circus audience received a well-deserved round of applause for the wonderful acrobatic stunt.
a. audience received a well-deserved
b. audience gave a well deserved
c. audience did receive a well deserved
d. audience gave a well-deserved
e. audience did get a well-deserved
11. Looking directly at me, Mother said, "These are your options: the choice is yours."
a. Mother said, "These are your options: the choice is
b. Mother said-these are your options, the choice is
c. Mother had said, These are your options; the choice is
d. Mother had said, "These are your options; the choice is
e. Mother said, "These are your options; the choice is
12. Porcupine is from Latin porcus, "pig," and spina, "spine."
a. porcus, "pig," and spina, "spine."
b. Porcus-pig and spina, "spine."
c. Porcus-pig, and Spina, "spine."
d. Porcus-Pig-,Spina-spine.
e. Porcus, "pig," and spina "spine".
13. Seeing the dolphins, some sharks, a killer whale, and a Moray eel made the visit to the marine park worthwhile.
a. a killer whale, and a Moray eel made the visit
b. a killer whale, and a moray eel made the visit
c. a killer whale and a moray eel makes the visit
d. a killer whale and a Moray eel makes the visit
e. a killer whale and a moray eel made the visit
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14. Still, the fact that a planet exists outside our solar system encourages hope that other solar systems exist, and in
them, perhaps, a planet that supports life.
A. that a planet exists outside our solar system encourages hope that other solar systems exist, and
B. that a Planet exists out side our solar system encourages hope that other solar systems exist and
C. could be that a planet exists outside our solar system encourages hope that other solar systems exist, and
D. that a planet exist outside our solar systems encourage hope that other solar systems exist, and
E. that a planet does exists out side our solar system encourages hope that other solar systems exist, and
15. Mail-order shopping can be convenient and timesaving with appropriate precautions, it is safe as well.
a. can be convenient and timesaving
b. can be convenient and timesaving;
c. should be convenient and time saving;
d. could be convenient and time saving;
e. can be convenient and time-saving;
16. Among the many fields of science, no matter what turns you on, there are several fields of study.
a. science, no matter what turns you on,
b. Science, no matter what turns you on,
c. Science, no matter which you chose,
d. Science, no matter which of these you chosee. science, no matter which you choose,
17. The fact that boxing is known to cause head injuries and brain damage should lead us to inform the public and
push for a ban on boxing.
a. should lead us to inform
b. could lead us to inform
c. should of led us to inform
d. will lead us to inform
e. should have led us to inform,
18. The first part of the test was on chemistry, the second on mathematics, and the third on english.
a. on mathematics, and the third on english.
b. on mathematics; and the third on English.
c. on Mathematics; and the third on English.
d. on mathematics, and the third on English.
e. on mathematics: and the third on English.
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19. The Diary of Anne Frank showed a young girl's courage during two years of hiding.
a. showed a young girl's courage
b. shows a young girl's courage
c. did show a young girls courage
d. has shown a young girl's courage
e. showed a young girls courage
20. In August my parents will be married for twenty-five years.
a. will be married for twenty-five years.
b. shall have been married for twenty-five years.
c. will have been married for twenty-five years.
d. will be married for twenty five years.
e. will have married for twenty-five years.
BASIC READING COMPREHENSION SCREENING
Please read each passage below and then answer the question at the end regarding the main idea of the passage:
Read the passage below and answer question 1
Americans have always been interested in their Presidents' wives. Many First Ladies have been remembered because of
the ways they have influenced their husbands. Other First Ladies have made the history books on their own.
At least two First Ladies, Bess Truman and Lady Bird Johnson, made it their business to send signals during their
husbands' speeches. When Lady Bird Johnson thought her husband was talking too long, she wrote a note and sent it up
to the platform. It read, "It's time to stop!" And he did. Once Bess Truman didn't like what her husband was saying on
television, so she phoned him and said, "If you can't talk more politely than that in public, you come right home."
Abigail Fillmore and Eliza Johnson actually taught their husbands, Millard Fillmore and Andrew Johnson, the thirteenth
and seventeenth Presidents. A schoolteacher, Abigail eventually married her pupil, Millard. When Eliza Johnson married
Andrew, he could not read or write, so she taught him herself.
It was First Lady Helen Taft's idea to plant the famous cherry trees in Washington, D. C. Each spring these blossoming
trees attract thousands of visitors to the nation's capital. Mrs. Taft also influenced the male members of her family and
the White House staff in a strange way: she convinced them to shave off their beards!
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Shortly after President Woodrow Wilson suffered a stroke, Edith Wilson unofficially took over most of the duties of the
Presidency until the end of her husband's term. Earlier, during World War I, Mrs. Wilson had sheep brought onto the
White House lawn to eat the grass. The sheep not only kept the lawn mowed, but provided wool for an auction
sponsored by the First Lady. Almost $100,000 was raised for the Red Cross.
Dolly Madison saw to it that a magnificent painting of George Washington was not destroyed during the War of 1812. As
the British marched toward Washington, D. C., she remained behind to rescue the painting, even after the guards had
left. The painting is the only object from the original White House that was not burned.
One of the most famous First Ladies was Eleanor Roosevelt, the wife of President Franklin D. Roosevelt. She was active
in political and social causes throughout her husband's tenure in office. After his death, she became famous for her
humanitarian work in the United Nations. She made life better for thousands of needy people around the world.
1. What is the main idea of this passage?
A. The Humanitarian work of the First Ladies is critical in American government.
B. Dolly Madison was the most influential president's wife.
C. Eleanor Roosevelt transformed the First Lady image.
D. The First Ladies are important figures in American culture.
E. The First Ladies are key supporters of the Presidents.
Read the passage below and answer question 2
Of the many kinds of vegetables grown all over the world, which remains the favorite of young and old alike? The
potato, of course.
Perhaps you know them as "taters," "spuds," or "Kennebees," or as "chips," "Idahoes," or even "shoestrings." No matter,
a potato by any other name is still a potato- the world's most widely grown vegetable. As a matter of fact, if you are an
average potato eater, you will put away at least 100 pounds of them each year.
That's only a tiny portion of the amount grown every year, however. Worldwide, the annual potato harvest is over 6
billion bags. Each bag contains 100 pounds of potatoes, some of them as large as four pounds each. Here in the United
States, farmers fill about 400 million bags a year. That may seem like a lot of "taters," but it leaves the United States a
distant third among world potato growers. Polish farmers dig up just over 800 million bags a year, while the Russians
lead the world with nearly 1.5 billion bags.
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The first potatoes were grown by the Incas of South America, more than 400 years ago. Their descendants in Ecuador
and Chile continue to grow the vegetable as high as 14,000 feet up in the Andes Mountains. (That's higher than any
other food will grow.) Early Spanish and English explorers shipped potatoes to Europe, and they found their way to
North America in the early 1600s.
People eat potatoes in many ways-baked, mashed, and roasted, to name just three. However, in the United States most
potatoes are devoured in the form of French fries. One fast-food chain alone sells more than $1 billion worth of fries
each year. No wonder, then, that the company pays particular attention to the way its fries are prepared.
Before any fry makes it to the people who eat at these popular restaurants, it must pass many separate tests. Fail any
one of these tests and the potato is rejected. To start with, only Russet Burbank potatoes are used. These Idaho
potatoes have less water content than other kinds, which can have as much as 80 percent water. Once cut into
"shoestrings" shapes, the potatoes are partly fried in a secret blend of oils, sprayed with liquid sugar to brown them,
steam dried at high heat, then flash frozen for shipment to individual restaurants.
Before shipping, every shoestring is measured. Forty percent of a batch must be between two and three inches long.
Another 40 percent has to be over three inches. What about the 20 percent that are left in the batch? Well, a few short
fries in a bag are okay, it seems.
So, now that you realize the enormous size and value of the potato crop, you can understand why most people agree
that this part of the food industry is no "small potatoes."
2. What is the main idea of this passage?
A. Potatoes from Ireland started the Potato Revolution.
B. The average American eats 50 pounds of potatoes a year.
C. French fries are made from potatoes.
D. Potatoes are a key vegetable in America.
E. The various terms for potatoes have a long history.
Read the passage below and answer question 3
Most people think that it's fine to be "busy as a beaver." Little do they know. Beavers may work hard, but often they
don't get very much done.
Beavers are supposed to be great tree cutters. It is true that a beaver can gnaw through a tree very quickly: A six-inch
birch takes about 10 minutes. But then what? Often the beaver does not make use of the tree. One expert says that
beavers waste one out of every five trees they cut. For one thing, they do not choose their trees wisely. One bunch of
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beavers cut down a cottonwood tree more than 100 feet tall. Then they found that they could not move it. In thick
woods, a tree sometimes won't fall down. It gets stuck in the other trees. Of course, the beaver doesn't think to cut
down the trees that are in the way. So a good tree goes to waste.
Some people think that beavers can make a tree fall the way they want it to. Not true. (In fact, beavers sometimes get
pinned under a falling tree.) When beavers cut a tree near a stream, it usually falls into the water, but they do not plan it
that way. The fact is that most trees lean toward the water to start with.
Now what about dam building? Most beaver dams are wonders of engineering. The best ones are strongly built of trees,
stones, and mud. They are wide at the bottom and narrow at the top.
Beavers think nothing of building a dam more than 200 feet long. One dam in Montana was more than 2,000 feet long.
The largest one ever seen was in New Hampshire: it stretched 4,000 feet, and made a lake large enough to hold 40
beaver homes. So beavers do build good dams. But they don't always build them in the right places. They just don't
plan. They will build a dam across the widest part of the stream. They don't try to find a place where the stream is
narrow. So a lot of their hard work is wasted.
Beavers should learn that it's not enough to be busy. You have to know what you're doing, too. For example, there was
one Oregon beaver that really was a worker. It decided to fix a leak in a man-made dam. After five days of work it gave
up. The leak it was trying to block was the lock that boats go through.
3. What is the main idea of this passage?
A. Beavers may be hard-working animals, but they don't always choose the most efficient mechanisms.
B. Beavers are excellent dam builders.
C. New Hampshire was the site of the largest beaver dam.
D. Beavers are well-developed tree cutters.
E. Beavers are poor surveyors of aquatic environments in some cases.
BASIC ELEMENTARY ALGEBRA SCREENING
Please solve each of the equations below for x:
1. x + 5 = 7
2. x – 6 = 10
3. 3x = 7
4
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4. 5 – (x + 2) = 5x
5. 5x + 2 = 6
6. 3(x -2) = 12
7. 45 = 3
X
8. X = 20 x 2
30
9. 26 = 8 + x
2
10. 16 = k_
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Registration Checklist and Application
Phoenix College Medical Assisting Program
PLEASE NOTE: Materials submitted as part of the application packet will NOT be returned to the applicant. Please
submit COPIES ONLY. DO NOT submit originals. All materials received are treated confidentially.
Thank you for your interest in the Phoenix College Medical Assisting Program. Please follow this application
checklist carefully to ensure that your application and documentation are complete and in order for the
selection committee. IT IS THE APPLICANT’S RESPONSIBILITY TO VERIFY THE APPLICATION IS COMPLETE.
The following items MUST be submitted with this packet for the application to be processed and the applicant
to be considered for admission to the program:

Completed Medical Assisting Program Application (begins page 19), including the signed
“Essential Abilities Requirements for Promotion and Retention” statement (page 7).

Copy of your high school diploma or GED and/or college transcripts.

Proof of passing grade in prerequisite course work (HCC145).

Placement test results showing that you TEST OUT OF ENG101, CRE101 and MAT091 or equivalent .
NOTE: Medical Front Office only students do not need to test for math.

Completed and signed Health and Safety Documentation Form (included in this packet) PLUS copies of
actual immunization records or laboratory titer results as supporting documentation of:
 Two MMR vaccinations in your lifetime or positive titer results
 Two varicella vaccinations in your lifetime or positive varicella titer result
 Negative 2-step TB skin tests or chest x-ray within the last year. NOTE: TB test/chest x-ray must be
kept current throughout the duration of the program, including externships.
 Three hepatitis B vaccinations or positive titer results (or signed waiver form – included in this
packet)
 Influenza vaccination (or signed waiver form – included in this packet)
 Tetanus AND pertussis vaccinations (TDaP) within the last 10 years (must be kept current
throughout the duration of the program including externships). NOTE: Td or tetanus alone is NOT
sufficient.
 Health and Safety Documentation statement signed by an M.D., D.O., N.P., or P.A.
 Copy of current CPR card for the Healthcare Provider – American Heart Association approved training
program (must be kept current throughout the duration of the program, including externships). MUST
state “training for healthcare provider” AND “American Heart Association approved” on the card.
 Copy of BOTH SIDES of your current Level I DPS Fingerprint Clearance Card (must be kept current
throughout the duration of the program including externships)
 Clinical Planning Form (initialed) (see page 25)
By signing below, I attest that I have completed this form and attached all of the required documentation listed above.
_____________________________________
_____________________________
Signature
Date
17
IMPORTANT!
PLEASE NOTE
Upon notification of provisional acceptance into the Medical Assisting Program for Fall 2014, all students
must submit to a background check to be performed by the Maricopa County Community College District
approved vendor. This will be done at the student’s own expense.
The Medical Assisting Program Director must receive proof that the student has passed this background
check, from the background check vendor, before the student will be permitted to register for medical
assisting classes. If this proof is not received, the student will not be given permission to register and will be
unable to participate in the Fall 2014 Medical Assisting program.
More information on obtaining the background check will be provided to students who are granted
provisional acceptance.
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Phoenix College
Medical Assisting Program Application Form – Fall 2014
To be considered for the Fall 2014 day Medical Assisting Program (NOTE: evening classes are not available at
this time), your application must be hand-delivered to the Phoenix College Advisement Center by 4:00 pm,
Wednesday, May 7, 2014.
Name: _____________________________________________Date of Birth:_____________ (must be 18 years
Last
First
Middle
of age or above)
Former name(s) (i.e. maiden name) that transcripts may be under ___________________________________
Student ID Number:___________Telephone______________(hm)___________________(wk)/(cell)
Mailing Address
_________________________________________________________________________
Street
City
State
Zip
Email: ___________________________________________________________________________________
I am applying for acceptance into the:
 Fall 2014 - MA Program (August 2014 through April 2014, 8:15 am to 5:00 pm Tuesdays,
Wednesdays, and Thursdays, followed by externships).
NOTE: Evening course offerings are not available for Fall 2014.
Healthcare/Work/Educational Experience
Are you currently employed?
____ Yes ____ No
If Yes, what is your current occupation? _______________________________________________________
What days and hours of the week do you work? _________________________________________________
If you are not currently employed in healthcare, have you ever worked in healthcare? ____ Yes ____ No
Have you taken courses in or enrolled in any other healthcare courses or programs? ____ Yes ____ No
If Yes, which courses or programs? ____________________________________________________________
Are you now enrolled in, or on a waiting list for, any other Health Education Program? ____ Yes ____ No
If yes, Program Name and location:___________________________________________________________
Anticipated start date ______________________________________________________________________
Educational Achievement
Check each level of education you have completed.
____ GED ____High School Diploma ____ Some College Work ____ AA Degree ____ Other
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Prerequisite Course Work
1. HCC145 is a PREREQUISITE (requirement) for admission into the Medical Assisting Program. Please
indicate the results for your HCC145 course in the table below. (NOTE: Students who are enrolled in
HCC145 at the time of application must successfully complete the course before August 2014.) NOTE:
If you completed medical terminology outside the Maricopa County Community College District, you
must provide a transcript for the class.
2. HCC130 is a PREREQUISITE (requirement) for admission into the Medical Assisting Program. Please
provide the information in the table below. (NOTE: Students who are enrolled in HCC130 at the time
of application must successfully complete the course before August 2014.) NOTE: If you completed a
Fundamentals of Healthcare or healthcare overview course outside the Maricopa County Community
College District, you must provide a transcript for the class.
3. Students must earn a grade of “B” or better in both of these healthcare core courses.
Date Completed
Course
Grade
College
In Progress(check)
HCC145 Medical Terminology for
Healthcare Workers
HCC130 Fundamentals in Healthcare
Delivery
Medical Assisting Program Statement of Interest
Please explain (in at least three full sentences) why you have chosen to apply for the Medical Assisting
Program or why you are interested in becoming a medical assistant. NOTE: Spelling, punctuation, and
grammar are important considerations in this written statement!
Are you now or might you later be interested in an Associates’ Degree (AAS) in Medical Assisting? _____________________
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Future Plans: Please discuss any future career goals beyond medical assisting (i.e. nursing, practice
management, etc.)
Describe what, if working in healthcare was not an option for you, you would like to do instead as a career.
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I certify that (initial next to each item):
____
I am responsible for providing ALL required information to complete my application and that failure to provide
all required information may delay my admission into the program or result in denial of admission altogether.
____
I understand admission into the program is conditional until I successfully complete all requirements and submit
all required documentation to the Medical Assisting program director, including updated information on
immunizations, CPR, etc. Failure to do so prior to the start date of the program will result in my not being
admitted into the program. Additionally, I understand that failure to maintain current status in all requirements
may result in my being dropped from the program, even if I am in good standing otherwise.
____
Upon acceptance into the program, I am responsible for obtaining all textbooks and required materials,
remaining current in my registration in classes, keeping current with any payment plans or financial aid
agreements, and maintaining good standing in the program and at Phoenix College. I further understand that,
should I be dropped from any courses for nonpayment, it is possible that I might not be readmitted to the
classes or to the program, at the discretion of the instructor and/or the program director.
____
I understand I must fully and willingly participate in ALL classroom, laboratory, and clinical program activities,
including my externship(s).
____
I understand that I will be required to submit to a drug test prior to my externship and that I am responsible for
the expense for this test.
____
I understand that if I am granted provisional acceptance into the Medical Assisting program, I must submit to
and pass a background check with the MCCCD-approved vendor (to be done at my own expense).
____
In cooperation and coordination with both the Phlebotomy Clinical Coordinator and the Medical Assisting
Clinical Coordinator, I must make myself available to fulfill the externship requirements of the medical assisting
program (at least 3 days per week) and that my externship(s) must be accomplished during regular business
hours for medical practices (M-F, approximately 8:00 am to 5:30 pm).
____
ALL information provided in this application is true, correct, and complete to the best of my knowledge. If any of
my information changes (i.e. name, phone number, address, etc.), it is my responsibility to notify the Medical
Assisting Program Director and the Phoenix College Admissions Office.
_______________________________________________
_______________
Applicant Signature
Date
Phoenix College, a Maricopa Community College, does not discriminate on a basis of race, color, gender, national origin, religion, handicap or age in application, admission, participation, access and treatment of persons in
instructional or employment programs and activities.
All application materials must be delivered to the reception desk of the Phoenix College Advisement Center by
4:00 pm on WEDNESDAY, May 7, 2014. Application and materials will be reviewed and students notified by email
of their provisional acceptance or their non-acceptance by the end of June, 2014. Please be sure that the
email address given in the application is current and correct or you will not receive your notification!
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MARICOPA COMMUNITY COLLEGE DISTRICT ALLIED HEALTH PROGRAMS
HEALTH AND SAFETY DOCUMENTATION
Student Name: ________________________________________ Date: __________________________________
Home Phone:__________________ Cell Phone:__________________ Student ID Number:__________________
A. MMR (Measles/Rubeola, Mumps, Rubella): Requires documented proof of two MMRs in lifetime or a positive titer for
each of these diseases.
1st MMR Date: _______________ 2nd MMR Date: _______________
OR
Date and results of titer: Measles/Rubeola _____________ Mumps ______________ Rubella _____________
B. Varicella (Chickenpox): Requires documented proof of two (2) vaccinations or positive IgG titer.
1st Varicella Date: ______________ 2nd Varicella Date: ______________
OR
Date & results of IgG titer:___________________________________________
C. TDaP immunization within the past 10 years. (Td is NOT sufficient for the Medical Assisting Program).
TDap Date: ____________________________________
D. Tuberculosis:
Two-Step Testing** for initial skin testing of adults who will be retested periodically
TWO-STEP TESTING
Use two-step testing* for initial skin testing of adults who will be retested periodically.
- If first test positive, consider the person infected.
- If first test negative, give second test 1-3 weeks later.
- If second test positive, consider person infected.
- If second test negative, consider person uninfected .
- If both parts of Two step test are negative then subsequent testing is done annually with one step procedure
INITIAL TEST:
Test Given_______________Date Read___________Result_____________________________
SECOND TEST (1-3 weeks after initial test):
Test Given: Date Read: _________ Result_____________________________
OR
Annual TB skin test (PPD):
Test Given______________ Date Read___________Result_____________________________
OR
Previous Positive PPD test:
Provide documentation of negative chest x-ray/evidence of TB disease free status
Date of chest x-ray____________________Result____________________________________
*If applicant has ever had a positive reaction, the test is not to be repeated. Other evidence that the applicant is free from Tuberculosis will be
required.
**Core Curriculum on Tuberculosis What the Clinician Should Know, Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, Georgia, 4 th Edition, 2000.
(continued)
23
MARICOPA COMMUNITY COLLEGE DISTRICT ALLIED HEALTH PROGRAMS
HEALTH AND SAFETY DOCUMENTATION
E. Hepatitis B: Documented evidence of completed series or positive antibody titer or declination. If beginning series, first
injection must be according to your Program’s required timeline and the series must be completed within 6 months.
Date of 1st injection: ___________ Date of 2nd injection: ___________ Date of 3rd injection: ____________
OR
Hep B Titer Date: _________________ Titer Results: _____________________________
OR
Signed Declination Form attached
F. Influenza: Documented evidence of influenza vaccination within the past year or declination.
Date of injection: ______________________________
OR
Signed Declination Form attached
G. Clearance for Participation in Clinical Practice
It is essential that allied health students be able to perform a number of physical activities in the clinical
portion of their programs. At a minimum, students will be required to lift patients and/or equipment,
stand for several hours at a time, and perform bending activities. Students who have a chronic illness or
condition must be maintained on current treatment and be able to implement their assigned
responsibilities. The clinical allied health experience also places students under considerable mental and
emotional stress as they undertake responsibilities and duties impacting patients’ lives. Students must be
able to demonstrate rational and appropriate behavior under stressful conditions.
I believe the applicant WILL __________ or WILL NOT __________ be able to function as an allied
health student as described above.
If not, explain:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Licensed Healthcare Provider (MD, DO, NP, or PA) Verification of Health and Safety
Print Name: _________________________________________________ Title: ___________________________________________
Signature: ___________________________________________________ Date: __________________________________________
Address: ___________________________________________________________________________________________________
City: _______________________________________________________ State: _________________________________
Telephone: _________________________________________
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Medical Assisting Program Clinical Planning
Clinical site availability is limited. Therefore, in order to participate in your externship, to successfully
complete the Medical Assisting Program, you must select one of the following clinical scheduling options.
Classroom training is scheduled from August 2014 through April 2014 on Tuesdays, Wednesdays, and
Thursdays from 8:15 am to 5:00 pm. The clinical externship follows the classroom training and must be
completed in one of the options described below. PLEASE CHOOSE ONE OF THE FOLLOWING OPTIONS:
 Option #1: Five days per week – Monday through Friday – during regular medical office hours
(approximately 8:00 am to 5:30 pm). With this option, externship can be completed in approximately
6-7 weeks.
- or  Option #2: Three days per week – during regular medical office hours – as above). With this option,
externship requires approximately 9-10 weeks to complete.
**If your availability for clinical externship does not fall into one of these options, you will not be
able to be placed in a clinical externship, and will not be able to complete the Medical Assisting
Program. **
__________________________________________
Applicant Signature
_______________________
Date
25
ADDITIONAL INFORMATION / QUESTIONS
Please indicate, in the space below, any additional information you would like to receive or questions you
would like to have answered if you are notified of your provisional acceptance into the Medical Assisting
Program. Thank you.
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