Phlebotomy Requirements and Application

Phlebotomy Orientation - Spring 2021

Agenda
2020-21 Academic Calendar

• Curriculum Checklist
  • Curriculum Checklists are to be used as a guide. Although your academic advisor can provide guidance, you are ultimately responsible for selecting courses that meet a program's graduation requirements. 2020-21 Phlebotomy Curriculum Checklist
• Background Checks
  • The clinical agencies that host the WITC Phlebotomy students have significantly increased their demands for background check scrutiny over the past several years. Background checks will not be completed until 90 days prior to start of the of the program. If there are no clinical agencies that will accept the student based on the background check history, the student must be excused from the Phlebotomy program, regardless of the student's academic standing. This is explained in further detail in the Background Check Disclosure form listed above, under Admission Requirements.
  • All Phlebotomy students are required to complete a Wisconsin Caregiver Background Check
  • If you are required to have a National Criminal Background Check, Minnesota Caregiver Background Check or other states as applicable, your program instructor will advise you on the process.
• Health Form and Directions 
  • Health Form and Directions

    • 1. Print directions and forms

    • 2. Read Hepatitis B information

    • 3. Complete health information and immunization pages of the form

    • 4. Take form and directions to your physical exam appointment

    • 5. Be sure the physical exam page gets signed and stamped

    • 6. Submit during the first semester per instructor's deadline

• Complete and Give to your Instructor
  • Functional Abilities Disclosure - listed above under Admission Requirements.  Read the functions and initial/sign the last page as described. Submit to instructor by designated due date
  • Confidentiality Statement
  • Acknowledgement of Risk Form

• Additional Information 

  • 2020-21 Phlebotomy Textlist
  • Insurance Information
  • Student Biographical Change Request Please print and use this form if you change your name, address or phone number(s). You should submit it to your local Student Services to be certain that the changes are entered in the main computer system.