College of the Great Smoky Mountains - Southwestern Community College, serving Jackson, Macon, and Swain Counties and Cherokee/ Qually Boundary
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Medical Lab Technology

Forms 

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For more information contact:
Andrea Kennedy, Program Coordinator
800.447.4091, ext. 312
Fax: 828.586.3129
andrea@southwesterncc.edu
Clinical Facility Fact Sheet (.pdf) To be completed by the MLT Clinical Affiliate and faxed or mailed to Andrea Kennedy
Clinical Observation Form The purpose of the clinical observation is not part of a curricular educational activity. It is a tool to assist the student in determining if a specific career is a choice he/she wants to pursue educationally at SCC.
Credit Card Authorization This process will immediately charge your credit card. Please be sure you are OFFICIALLY registered before submitting payment. You may contact the Business Office by email at cashier@southwesterncc.edu or by phone 828.586.4091, ext. 290.
Exam Proctor Form - revised 8/08 To be completed by exam proctor and signed by both proctor and student.
Faculty Fact Sheet To be completed by each member of the staff with teaching, tutorial, or supervision responsibilities for MLT Students.
Policy Manual Agreement This form states that the student has read the MLT Policy Manual and understands and agrees to adhere to the policies and procedures.
Seminar Leave  
Student Declaration of meeting Technical / Academic Standards, Physical Requirements and Environmental Working Conditions Self-appraisal form of student's ability to perform procedures required.
Student Informed Refusal Student's decline of Hepatitis B vaccination
Student Health / Medical Complete medical form designed to help insure the health and well-being of students as well as patients and clients.

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 Last updated 9/2/08


 
Southwestern Community College • 447 College Drive • Sylva, NC 28779
828·586·4091 or 800·447·4091
fax 828·586·3129