Wenatchee Valley College Allied Health Packet Revised 06.27.2019
PLEASE KEEP PACKET STAPLED AND FOLLOW DIRECTIONS CLOSELY
Medme
IMMUNIZATION RECORDS AND MEDICAL DOCUMENT MANAGER
Documentation of student immunization status is essential to ensure the health and safety of students and the
patients/clients/residents in healthcare agencies that provide clinical learning experiences. It is the student’s
responsibility to ensure that adequate documentation of the listed requirements is loaded in the Medical
Document Manager.
Lack of compliance with any of these requirements will prevent a student from entering the clinical area and
completing his/her clinical training. Subsequent updates require that the student submit documentation with the
Document Manager. Lapses in renewal or updating of required PPD testing, CPR training, and purchase of
insurance during the program will also prevent a student from entering the clinical area and will jeopardize the
student’s enrollment in the program.
All requirements will be loaded into the Medical Document Manager called Complio®
http://www.wenatcheevalleycompliance.com
Please see the last page of this packet for Student Instructions and check due date.
Once you have purchased your package with the package code, you will be directed to set up your Complio®
account. From this account you will load your documentation into the Medical Documentation Manager.
Official documentation is required: Each record must be on the healthcare provider’s letterhead, have the
student’s name, the date of immunization, the signature of the person administering the immunization, and the lot
number of the vaccine administered.
Wenatchee Valley College reserves the right to add to or modify these requirements as needed.
Complio® BACKGROUND CHECK
Washington State law (RCW 43.43.832) permits businesses or organizations that provide services to children,
vulnerable adults, or developmentally disabled persons to request criminal history records. Facilities used for clinical
work experience require clearance prior to the student being allowed to work in the facility. Prior to beginning any
Name: _______________________________________ Email Address: ________________________________
(First, Middle, Last)
WVC Email Address:____________________________
Address: _____________________________________
Cell Phone Number: ____________________________
Phone Number: _______________________________
Student ID Number: __________________________
Alternate Phone Number: _______________________ Program:_____________________________________
Reviewed by program director
Signature_______________
Date___________________
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
clinical work experience, a criminal record check (Complio®) is required of all students accepted into the health
science programs at WVC, dated not more than forty-five (45) days prior to the beginning of the Program. The forms
and instructions to initiate these background checks are included in this information packet. Students should note
that facilities might require certain background checks. DSHS background checks might be requested at certain
facilities. Clinical sites can request a background check to be repeated.
Students need to be aware that conviction of certain crimes may prevent completion of the clinical course
requirements of the Program and may also prevent future licensing and employment in the health field.
Using the Student Instructions (form attached) to order your background check from
http://www.wenatcheevalleycompliance.com. The background check cannot be dated more than 45 days before
the start of the program.
TWO-STEP PPD or QuantiFERON® TB Gold Test (read this part carefully)
An initial negative two-step PPD is required, which means that two (2) separate tuberculin skin tests have been
placed one (1) to three (3) weeks apart. Each test is read 48 to 72 hours after it has been placed. This requires
four (4) visits to your healthcare provider. Documentation must show the dates and results of the tests, as well
as the lot numbers of the vaccine. Students should not get any other vaccination with the first PPD.
Students with a positive PPD must provide documentation of a chest x-ray, treatment (if necessary), and a
release to work in a healthcare setting from a doctor or healthcare provider.
Tuberculin skin tests are required each year (annual renewal) and must be placed and read within one year
following the initial two-step PPD.
As some facilities now utilize the QuantiFERON® TB Gold Test in place of the PPD, WVC will accept this
method. This does not require a two-step initial skin test; however, the test must be performed annually.
If the student goes back to the PPD the year after having had the QuantiFERON® TB Fold, the two-step
process is required.
PPD Timeline:
Appointment with
Healthcare Provider
Action Time Interval
First appointment Initial injection
Second appointment Read results
48 to 72 hours from date/
time of injection; cannot be
prior to 48 hours or later
than 72 hours.
Third appointment Second injection
One to three weeks after
initial injection; cannot be
less than one week or more
than three weeks.
Fourth appointment Read results
48 to 72 hours from date/
time of injection; cannot be
prior to 48 hours or later
than 72 hours.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
HEPATITIS B VACCINE (complete series of three [3] injections)
or positive titer with lab documentation
Students must have the first and second injections prior to entering the Program. Adults getting Hepatitis B vaccine
should get three (3) doses, with the second dose given four (4) weeks after the first and the third dose five (5)
months after the first. Your healthcare provider can tell you about other dosing schedules that might be used in
certain circumstances. Positive titer (blood test-lab reports required) is acceptable.
TWO MMR (Measles, Mumps, Rubella) VACCINES
or positive titer with lab documentation
Students must provide presumptive evidence of immunity to measles, rubella, and mumps. Presumptive evidence
includes documented administration of two doses of live virus vaccine or positive titers (blood test for immunity of
Mumps, Rubella and Rubeola-lab reports for all three required).
TETANUS/DIPHTHERIA/PERTUSSIS (Tdap) IMMUNIZATION
Students must have had a Tetanus/Diphtheria/ Pertussis injection, or booster, within the last ten (10) years.
TWO CHICKENPOX (VARICELLA) VACCINES
or positive titer with lab documentation
Students must have had two (2) Chickenpox injections or a positive Varicella titer (blood test for immunity-lab
reports required).
FLU VACCINE
Depending on the availability of flu vaccine, each student is required to be vaccinated by the announced date,
typically after October and before December each year. Leave the field blank until required.
MEDICAL INSURANCE
(pertains to student accidents during clinical experiences or in lab class)
Clinical affiliates associated with WVC allied health programs require that students provide proof of accident
insurance. Students refusing to provide proof of accident insurance will not be allowed access to clinical agencies
to complete clinical course work. Students must maintain this coverage throughout the Program to cover any
accident that might occur while at a clinical site. Even though a clinical facility may provide necessary emergency
care or first aid for an accident (i.e., needle stick), a clinical facility has no obligation to furnish medical or surgical
care to any student. The student bears responsibility for the cost of such care, as well as for any follow-up care.
For students who do not have insurance, WVC allied health programs recommends the carrier approved by the
Washington State Board of Community and Technical Colleges. The cost is approximately $45 per quarter. The
student may enroll online: http://4studenthealth.relationinsurance.com/
A copy of the student’s current personal medical insurance OR a copy of the student’s Relation insurance receipt is
to be submitted with the Document Manager. If the student is using personal insurance through a plan at work,
etc., it is advisable to check with the insurance carrier to make sure it will cover an accident incurred by a student
at a clinical site.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
CPR FOR HEALTHCARE PROVIDERS CARD, HIV/AIDS CERTIFICATE
and DRUG SCREEN
CPR FOR HEALTH CARE PROVIDERS
Students are required to maintain CPR Certification for Healthcare Providers, and the card must be renewed every
two years. The CPR card must be issued by a person or facility qualified specifically to instruct CPR for healthcare
providers (i.e., American Heart Association, American Red Cross, Central Washington Hospital [662.1511], and the
WVC Health 051 class). Online classes will not be accepted.
HIV/AIDS TRAINING CERTIFICATE
Seven (7) hours of HIV/AIDS training is required. This may be obtained by taking HCA 113 (HIV/AIDS Education) for
one (1) credit at WVC. Also, an online course is offered through Wild Iris at www.nursingceu.com
. The Certificate is
required, transcripts will not be accepted.
NEGATIVE DRUG SCREEN
Students must provide results of a standard, ten-panel drug screen, either urine-based or oral swab, dated not
more
than forty-five (45) days prior to the beginning of the Program (see attached drug screen information
document).
WVC has chosen Complio® as an approved source for drug screening. After students have set up their Complio®
account, they must:
• Have a Chain of Custody form (COC), which will come in the mail to the student after purchase of the drug
screen.
• Take the COC to Confluence Health (either the Wenatchee Valley Clinic or the Omak Clinic) and provide the
sample.
• Refrain from consuming large amounts of liquids just prior to the test.
• If you choose “other” you will select a Quest lab in your area. A chain of custody form will be emailed to
you with instructions for the Quest lab.
Results will be forwarded by collection site to Complio®
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
FORMS
STUDENT DISCLOSURE FORM: Complete, sign, and date.
If student has been convicted of a crime, student must contact the Allied Health office (509-682-6660).
Students need to be aware that conviction of certain crimes may prevent completion of the clinical course
requirements of the Program and may also prevent future licensing and employment in the health field.
ABUSE ACT FORM: Sign in presence of a witness (non-family member); witness must also sign.
PERSONAL MEDICAL RECORD: Student is to complete; must be signed by a healthcare provider.
STUDENT RELEASE FORM: Complete and sign.
STUDENT CONFIDENTIALITY STATEMENT: Complete and sign.
This packet must be on file in the Allied Health Office, and required documentation must be submitted with the
Medical Document Manager by program due date or prior to entering any Allied Health program clinical sites.
I certify with my signature that I have read and understand the above requirements and that the information
above and documentation submitted pertaining to me is complete and accurate.
___________________________________________________ ____________________________
Signature Date
REMINDER: Keep your original documents for your personal records.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
PERSONAL INFORMATION FORM
(Please print legibly)
Part I: General Information
Full Name: Program:
DOB: Age: _________________________
Gender: _________________________ Academic Year:
Current Address/Phone Number:
Street: City/State:
Cell Phone: ___ Zip Code:
Alternate Phone: ______________________
In case of emergency please notify:
Name: Phone:
Ethnic Origin
Required information for federal/state statistical reporting on the annual nursing report.
__ Alaskan Native or American Indian
__ Black/African America
__ Chinese
__ Filipino
__ Japanese
__ Korean
__ Mexican, Mexican American, Chicano
__ Puerto Rican
__ Cuban
__ Other Spanish/Hispanic/Latino
__ Vietnamese
__ White
__ Other Asian or Pacific Islander
__ Other
Part II: Health History
Date of last health examination:
Name of healthcare provider: (Optional)
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Please identify any health conditions/illnesses or injuries that required medical treatment;
please check all that apply.
Heart Defect/Disease
Hypertension
Asthma or other respiratory condition
Diabetes or other endocrine condition
Seizure Disorder
Neurological problem
Bleeding or clotting disorder
Musculoskeletal problem/condition
Any infection within last year
Any traumatic injury within last year
Mental and/or emotional condition
Substance abuse
Other
Further explanation of any items that are checked:
Do you have any allergies? If yes, please specify.
Please list all medications that you take regularly.
Part III: Statement of ability to function as a student in an Allied Health program.
Do you have a visual impairment? Yes _____ No ____
If so, is it corrected? Yes _____ No ____
Do you have a hearing impairment? Yes _____ No ____
If so, is it corrected? Yes _____ No ____
Can you lift up to 50 lbs.? Yes _____ No ____
Can you carry up to 20 lbs.? Yes _____ No ____
Can you sit for 4 hours? Yes _____ No ____
Can you stand and/or walk unassisted
for up to 12 hours? Yes _____ No ____
Can you use both hands? Yes _____ No ____
Please rate your ability to cope with stressful situations.
I am able to cope with stress:
Always Usually Not Always Seldom
Please feel free to provide more information on an additional sheet.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Wenatchee Valley College
Allied Health Department
Health Care Provider Statement/Medical Release
Prior to entrance into a Health Sciences program, a medical release must be completed by your health care provider. If at any
time during the program, your health status changes, you must have your health care provider complete the medical release
form.
All Allied Health students must be physically, emotionally, and academically able to safely demonstrate completion of all
required learning activities. Learning activities include successful completion of course, clinical, and theory objectives in order
to successfully complete the curriculum. All students must submit the health care provider statement or medical release,
medical history, and student physical ability requirements. Allied Health students will be treated respectfully regardless of race,
color, national origin, gender, age, religion, or disability. In turn, Allied Health students will treat their clients respectfully
regardless of race, color, national origin, gender, age, religion, or disability. Wenatchee Valley College provides reasonable
accommodation and services to otherwise qualified students who are physically and learning disabled unless making the
accommodation poses an undue hardship on the college or jeopardizes client safety.
Allied Health students will be in clinical courses, requiring the safe application of both gross and fine motor skills, as well as
critical thinking skills. All of these skills are inherent elements of clinical practice. Usual and required activities routinely
conducted by students include care for clients that range from ambulatory to comatose, and involve all age ranges from
premature infants to gerontology clients. There always exists potential exposure to communicable diseases and other
pathogens.
Health Care Provider Instructions: Please complete the following questions with the understanding of the academic role and
clinical performance requirements of Allied Health students. Please do not attach any medical records.
1. Does the student have any limitations identified on the medical history questionnaire or disabilities that would
interfere with the performance of the academic or clinical requirements specified above on this form? If yes, specify.
Yes (if yes, specify and continue to question 2 and 3 below. Please sign and print name below)
No (if no, please sign and print name and address below)
2. Based upon question #1, what special accommodations are medically necessary to assist the student with academic
and clinical performance?
3. State any instructions or limitations with which the student has been advised to comply.
______________________________________________________________________________________
Signature of Health Care Provider (credentials) Date
______________________________________________________________________________________
Print Name of Health Care Provider Office Address (include city, state, zip)
Note: The signatures of both the student and health care provider are required for admission. The names and information must be legible to be accepted. Illegible
documents will be returned to the student. Office (509) 682-6660/ Fax (509) 682-6661.
STUDENT INSTRUCTIONS: I understand the student academic role and clinical performance requirements and agree that I have the
primary responsibility of my own health status. I agree that I will not knowingly place myself, clients or others in unsafe situations based
upon my physical, mental, or emotional limitations. I have completed and signed the physical abilities requirements form. I authorize my
health care provider to release to Wenatchee Valley College Allied Health Programs the information requested below concerning my
health status. If I am not truthful or falsify the health policy documents, I understand I will be withdrawn from the Program.
Printed name of student:
Signature of student: Date:
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Wenatchee Valley College
Allied Health Department
Medical History Questionnaire
Name: ______________________________________ Date: ____________________________
(Last First Middle)
Home Address: _______________________________ Phone: ___________________________
Gender: _____________________________________ Date of Birth: ______________________
A. Check either yes or no; give details of a “yes” answer in section B that follows. Being untruthful or withholding
information will result in dismissal from the Allied Health Program.
Have you ever been treated for conditions or had indications of:
Yes
No
Yes
No
1. Eye/vision problems
15. Skin rashes or eczema
2. High blood pressure
16. Fainting or dizziness
3. Tuberculosis or lung disease
17. Head injury
4. Asthma
18. Convulsions/Seizures
5. Diabetes
19. Varicose veins
6. Emphysema
20. Kidney/bladder problems
7. Epilepsy or seizure disorder
21. Allergies
8. Arthritis/Rheumatism/Bursitis
22. Hemorrhoids
9. Disease or pain of bones/joints
23. Hepatitis
10. Ear problems
24. Psychiatric problems
11. Muscle spasms
25. History of substance abuse
12. Reaction to medications
26. Anemia/blood disorders
13. Reaction to chemicals
27. Heart problems
14. Neck, shoulder, or back problems
B. List below full details to questions answered “YES” in Section A, above. Use a separate sheet of paper if
needed. A medical release for any of the above will be required for admission. Any other conditions will be
considered individually and require a medical release.
Question #
Condition/Treatment/Management
Date
C. Do you take medicine regularly? Yes No If yes, list all prescribed and over-the-counter or herbal
medications and reason for taking (use a separate sheet if needed):
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Wenatchee Valley College
Allied Health Department
Physical Abilities Requirements
Student Name: ________________________________________________________________
R: Regularly O: Occasionally
Abilities
R
O
Measurable Descriptor
Vision: Corrected or Normal
X
Ability to read syringes, labels, instructions, and equipment
Color Vision
X
Color coded equipment
Hearing
X
Ability to hear through some equipment and noisy environments
Touch
Temperature Discrimination
X
Palpation pulses & discriminate temperature & sensation; Use equipment
requiring fine motor skills
Smell
X
Differentiate body odors, drainage, skin, and stool odor
Finger Dexterity/
X
Manipulation of equipment, dressings, IV and other functions requiring
finger dexterity; assessment
Intelligible oral
communication
X
Communication with clients, staff members, peers and faculty
Appropriate non-verbal
communication
X
Therapeutic communication with client, rapport and trust with client and
health care team
Pushing
X
Lbs/ft: 100, equipment, carts with and without clients
Pulling
X
Lbs/ft: 50, equipment, and client carts
Lifting
X
Lbs/ft: 50, clients, equipment, and supplies
Floor to waist
X
Lbs 75: 3 man lift of patients
Reaching forward
X
Moving clients and equipment
Carrying
X
Lbs 50
Standing and Walking
X
Long periods, up to eight hours
Sitting
X
Infrequent and short periods, break and lunch
Stooping/Bending
X
Infrequent and short periods; adjusting equipment
Kneeling/Crouching
X
Infrequent and short periods; adjusting equipment
Running
X
Infrequent, emergency situations
Crawling
X
Short periods, emergency, adjusting equipment
Climbing
X
Infrequent, patient care activities
Stairs (ascending/descending)
X
Infrequent, emergency situations
Turning (head/neck/waist)
X
Frequent extended periods; may position for long periods
Repetitive arm movement
X
Key Boards/Computer
I have read, understand, and accept the above working conditions expected of an Allied Health student in the
academic and clinical setting and certify that I am able to meet these requirements.
_________________________________________________
Student Signature
_________________________________________________
Date
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Wenatchee Valley College
Allied Health Department
Student Health Statement/Medical Release Form
Prior to entrance into a Health Sciences program, a medical release must be completed by your health
care provider. If at any time during the program, your health status changes, you must have your health
care provider complete the medical release form.
All Allied Health students must be physically, emotionally, and academically able to safely demonstrate completion of all
required learning activities. Learning activities include successful completion of course, clinical, and theory objectives in order
to successfully complete the curriculum. Allied Health students will be treated in their academic opportunities and in turn treat
their clients respectfully regardless of race, color, national origin, gender, age, religion, or disability. Wenatchee Valley College
provides reasonable accommodation and services to otherwise qualified students who are physically and learning disabled
unless making the accommodation poses an undue hardship on the college or jeopardizes client safety.
Allied Health students will be in clinical courses, requiring the safe application of both gross and fine motor skills, as well as
critical thinking skills. All of these skills are inherent elements of practice. Usual and required activities routinely conducted by
students include care for clients that may be ambulatory or comatose and involves all age ranges from premature infants to
gerontology clients. Required abilities are walking, standing for up to eight hours, bending, reaching, turning, listening,
observation, and moderate to heavy lifting (at least 50 pounds). There always exists potential exposure to communicable
diseases and other pathogens.
Note: This form with the student’s signature is required prior to return to clinical following absence due to health problems or
changes in health status. The faculty reserves the right to request the student to complete a student health statement in the
event the student demonstrates evidence of clinical performance affected by physical, emotional, or mental limitations.
Office Use Only
Date and Time Received:
Program Director:
Clinical Site
Comments:
Approval for class/clinical yes no
Program Director Signature:
STUDENT INSTRUCTIONS: I understand the student academic role and clinical performance requirements and agree that I have the
primary responsibility of my own health status. I agree that I will not knowingly place myself, clients, or others in unsafe situations
based upon my physical, mental, or emotional limitations. I have completed and signed the physical abilities requirements form. I
authorize my health care provider to release to Wenatchee Valley College Allied Health Program the information requested below
concerning my health status.
Printed name of student:
Signature of student: Date:
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Student Disclosure Form
1. Have you ever been convicted of a crime?
Yes_____ No_____ Initials__________
Students need to be aware that conviction of certain crimes may prevent completion of the clinical course requirements of the
Program and may also prevent future licensing and employment in the health field.
If yes, please list the conviction(s) and the degree(s):
_________________________________________________________________________________________
2. Do you have charges (pending) against you for any crime?
Yes_____ No______ Initials__________
If yes, please list the pending charge(s) and the degree(s):
_________________________________________________________________________________________
3. Are you aware that you must provide a background check through Complio®, and a DSHS background check for certain programs?
Yes_____ No_____ Initials__________
4. Do you understand that some criminal convictions may prevent you from completing a program of study?
Yes_____ No_____ Initials__________
5. Do you understand that you need to provide documentation of specified immunizations or evidence of immunity to specified diseases in order to
participate in Allied Health programs?
Yes_____ No_____ Initials__________
6. Are you aware that you must provide a negative drug screen for Allied Health programs?
Yes_____ No_____ Initials__________
7. Do you understand that your behavior during the time of training for a particular occupation needs to comply with both the Wenatchee Valley
College Student Code of Conduct (see the WVC Student Handbook) and the code of conduct/ethics/standards that regulate the occupation for
which you will be trained?
Yes_____ No_____ Initials__________
8. Do you understand that by breaking the code of conduct for an occupation or the WVC Student Code of Conduct you may be subjected to
disciplinary action, including suspension from the program?
Yes_____ No_____ Initials__________
9. Do you understand that there are procedures and policies at Wenatchee Valley College that govern student grievances and disciplinary
actions?
Yes_____ No_____ Initials__________
_______________________________________________ ______________________________________
Signature Date Name (printed legibly)
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
WENATCHEE VALLEY COLLEGE - ALLIED HEALTH PROGRAMS
CHILD AND ADULT ABUSE INFORMATION ACT DISCLOSURE PURSUANT TO RCW 43.43.834
Answer each item. If the answer is YES to any item, indicate the charge or finding, the date, and the court(s) involved.
1. Have you ever been convicted of any crimes against children or other persons, as follows: aggravated murder; first or second
degree murder; first or second degree kidnapping, first, second, or third degree assault; first, second or third degree rape of a child;
first or second degree robbery; first degree arson; first degree burglary; first or second degree manslaughter; first or second degree
extortion; indecent liberties; incest; vehicular homicide; first degree promoting prostitution; communication with a minor; unlawful
imprisonment; simple assault; sexual exploitation of minors; first or second degree criminal mistreatment; child abuse or neglect as
defined in RCW 26.44.020; first or second degree custodial interference; malicious harassment; first, second, or third degree child
molestation, first or second degree sexual misconduct with a minor; patronizing a juvenile prostitute; child abandonment;
promoting pornography; selling or distributing erotic material to a minor; custodial assault; violation of child abuse restraining
order; child buying or selling; prostitution? ANSWER
If YES, explain
2. Have you ever been convicted of crimes relating to the financial exploitation if the victim was a vulnerable adult, as follows: first,
second, or third degree theft; first or second degree robbery:, forgery? ANSWER
If YES, explain
3. Have you ever been found guilty in any dependency action under RCW 13.34.030(2)(b) to have sexually assaulted or exploited any
minor or to have physically abused any minor? ANSWER
If YES, explain
4. Have you ever been found in any domestic relations proceeding under Title 26 RCW to have sexually abused or exploited any minor
or to have physically abused any minor? ANSWER
If YES, explain
5. Have you ever been found in any disciplinary board final decision to have sexually or physically abused or exploited any minor or
developmentally disabled person or to have abused or financially exploited any vulnerable adult?
ANSWER
If YES, explain
6. Have you ever been found in any protection proceeding under chapter 74.34 RCW, to have abused or financially exploited a
vulnerable adult? ANSWER
If YES, explain
Pursuant to RCW 9A.72.085, I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true
and correct.
PROGRAM (Please check one)
o NURSING ASSISTANT
o NURSING - Omak
o CHEMICAL DEPENDENCY
o NURSING - Wenatchee
o MEDICAL ASSISTANT
o RADIOLOGIC TECHNOLOGY
o MEDICAL LABORATORY TECHNOLOGY
YOUR SIGNATURE MUST BE WITNESSED BY A NON-FAMILY MEMBER.
NAME (Please Print) SIGNATURE DATE
WITNESS SIGNATURE BUSINESS OR ORGANIZATION ADDRESS
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Title 43 RCW: State Government-Executive
43.43.830 Background checks-Access to children or vulnerable persons-Definitions. Unless the context clearly requires other-
wise, the definitions in this section apply throughout RCW 43.43.830 through 43.43.840.
(1 “Applicant” means:
(a) Any prospective employee who will or may have unsupervised access to children under sixteen years of age or developmentally
disabled persons or vulnerable adults during the course of his or her employment or involvement with the business or organization;
(b) Any prospective volunteer who will have regularly scheduled unsupervised access to children under sixteen years of age,
developmentally disabled persons, or vulnerable adults during the course of his or her employment or involvement with the business or
organization under circumstances where such access will or may involve groups of (I) five or fewer children under twelve years of age,
(ii) three or fewer children between twelve and sixteen years of age, (iii) developmentally disabled persons, or (iv) vulnerable adults; or
(c) Any prospective adoptive parent, as defined in RCW 26.33.020.
(2) “Business or organization” means a business or organization licensed in this state, any agency of the state, or other
governmental entity, that educates, trains, treats, supervises, or provides recreation to developmentally disabled persons, vulnerable
adults, or children under sixteen years of age, including school districts and educational service districts.
(3) “Civil adjudication” means a specific court finding of sexual abuse or exploitation or physical abuse in a dependency action
under RCW 13.34.040 or in a domestic relations action under Title 26 RCW. In the case of vulnerable adults, civil adjudication means a
specific court finding of abuse or financial exploitation in a protection proceeding under chapter 74.34 RCW. It does not include
administrative proceedings. The term “civil adjudication” is further limited to court findings that identify as the perpetrator of the abuse a
named individual, over the age of eighteen years, who was a party to the dependency or dissolution proceeding or was a respondent in
a protection proceeding in which the finding was made and who contested the allegation of abuse or exploitation.
(4) “Conviction record” means “conviction record” information as defined in RCW 10.97.030(3) relating to a crime against children or
other persons committed by either an adult or a juvenile. It does not include a conviction for an offense that has been the subject of a
pardon, annulment, or other equivalent procedure based on a finding of innocence. It does include convictions for offenses for which
the defendant received a deferred or suspended sentence, unless the record has been expunged according to law.
(5) “Crime against children or other persons” means a conviction of any of the following offenses: Aggravated murder; first or
second degree murder, first or second degree kidnapping; first, second, or third degree assault; first, second, or third degree assault of
a child; first, second, or third degree rape; first, second, or third degree rape of a child; first or second degree robbery; first degree arson;
first degree burglary; first or second degree manslaughter; first or second degree extortion; indecent liberties; incest; vehicular homicide;
first degree promoting prostitution; communication with a minor; unlawful imprisonment; simple assault; sexual exploitation of minors;
first or second degree criminal mistreatment; child abuse or neglect as defined in RCW 26.44.020; first or second degree custodial
interference; malicious harassment; first, second, or third degree child molestation; first or second degree sexual misconduct with a
minor; first or second degree rape of a child; patronizing a juvenile prostitute; child abandonment; promoting pornography; selling or
distributing erotic material to a minor; custodial assault; violation of child abuse restraining order; child buying or selling; prostitution;
felony indecent exposure; or any of these crimes as they may be renamed in the future.
(6) “Crimes relating to financial exploitation” means a conviction for first, second, or third degree extortion; first, second, or third
degree theft; first or second degree robbery; forger; or any of these crimes as they may be renamed in the future.
(7) “Disciplinary board final decision” means any final decision issued by the disciplinary board or the director of the department
of licensing for the following businesses or professions:
(a) Chiropractic;
(b) Dentistry;
(c) Dental hygiene:
(d) Massage;
(e) Midwifery;
(f) Naturopathy;
(g) Osteopathy;
(h) Physical therapy;
(I) Physicians;
(j) Practical nursing;
(k) Registered nursing;
(l) Psychology; and
(m) Real estate brokers and salesmen.
(8) “Unsupervised” means not in the presence of:
(a) Another employee or volunteer from the same business or organization as the applicant; or
(b) Any relative or guardian of any of the children or developmentally disabled person to which the applicant has access during
the course of his or her employment or involvement with the business or organization.
(9) “Vulnerable adult” means a person sixty years of age or older who has the functional, mental, or physical inability to care for
himself or herself or a patient in a state hospital as defined in chapter 72, 23 RCW.
(10) “Financial exploitation” means the illegal or improper use of a vulnerable adult or that adult’s resources for another person’s
profit or advantage.
(11) “Agency” means any person, firm, partnership, association, corporation, or facility which receives, provides services to ,
houses or otherwise cares for vulnerable adults.[1992 c 145 § 16. Prior: 1990 c 146 § 8: 1990 c 3 § 1101; prior: 1989 c 334 § 1: 1989 c
90 § 1; 1987 c 486 § 1.]Index, part headings not law-Severability-Effective dates-Application-1990 c 3: See RCW 18.155.900
through 18.155.902. Developmentally disabled person; RCW 41.06.475. State hospitals: RCW 72.23.035
43.43.832 Background checks-Disclosure of child abuse or financial exploitation activity. (1) The legislature finds that
businesses and organizations providing services to children, developmentally disable persons, and vulnerable adults need adequate
information to determine which employees or licensees to hire or engage. Therefore, the Washington state patrol criminal identification
system may disclose, upon the request of a business or organizations defined in RCW 43.43.830, an applicant’s record for convictions
of offenses against children or other persons, convictions for crimes relating to financial exploitation, but only if the victim was a
vulnerable adult, adjudications of child abuse in a civil action, the issuance of a protection order against the respondent under chapter
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
74.34 RCW, and disciplinary board final decisions and any subsequent criminal charges associated with the conduct that is the subject
of the disciplinary board final decision. When necessary, applicants may be employed on a conditional basis pending completion of
such a background investigation.
(2) The legislature also finds that the state board of education may request of the Washington state patrol criminal identification
system information regarding a certificate applicant’s record for convictions under subsection (1) of this section. (3) The legislature
also finds that law enforcement agencies, the office of the attorney general, prosecuting authorities, and the department of social and
health services may request this same information to aid in the investigation and prosecution of child, developmentally disable person,
and vulnerable adult abuse cases and to protect children and adults from further incidents of abuse.
(4) The legislature further finds that the department of social and health services, when considering persons for state positions
directly responsible for the care, supervision, or treatment of children, developmentally disabled persons, or vulnerable adults or when
licensing or authorizing such person or agencies pursuant to its authority under chapter 74.15, 18.51, 18.20, or 72.23 RCW, or any later-
enacted statue which purpose is to license or regulate a facility which handles vulnerable adults, must consider the information listed in
subsection (1) of this section. However, when necessary, persons may be employed on a conditional basis pending completion of the
background investigation. The state personnel board shall adopt rules to accomplish the purposes of this subsection as it applies to
state employees. [1990 c 3 §1102. Prior: 1989 c 334 § 2; 1989 c 90 § 2; 1987 c 486 §s.] Index, part headings not law-Severability-
Effective dates-Application-1990 c 3: See RCW 18.155.900 through 18.155.902.
43.43.834 Background checks by business, organization, or insurance company-Limitations-Civil liability. (1) A business or
organization shall not make an inquiry to the Washington state patrol under RCW 43.43.832 or an equivalent inquiry to a federal law
enforcement agency unless the business or organization has notified the applicant who has been offered a position as an employee or
volunteer, that an inquiry may be made.
(2) A business or organization shall require each applicant to disclose to the business or organization whether the applicant has
been:
(a) Convicted of crimes against children or other persons;
(b) Convicted of crimes relating to financial exploitation if the victim was a vulnerable adult;
(c) Found in any dependency action under RCW 13.34.040 to have sexually assaulted or exploited any minor or to have physically
abused any minor;
(d) Found by a court in a domestic relations proceeding under Title 26 RCW to have sexually abused or exploited any minor or to
have physically abused any minor;
(e) Found in any disciplinary board final decision to have sexually or physically abused or exploited any minor or developmentally
disabled person or to have abused or financially exploited any vulnerable adult; or
(f) Found by a court in a protection proceeding under chapter 74.34 RCW, to have abused or financially exploited a vulnerable
adult.
The disclosure shall be made in writing and signed by the applicant and sworn under penalty of perjury. The disclosure sheet shall
specify all crimes against children or other persons and all crimes relating to financial exploitation as defined in RCW 43.43.830 in which
the victim was a vulnerable adult.
(3) The business or organization shall pay such reasonable fee for the records check as the state patrol may require under RCW
43.43.838.
(4) The business or organization shall notify the applicant of the state patrol’s response within ten days after receipt by the
business or organization. The employer shall provide a copy of the response to the applicant and shall notify the applicant of such
availability.
(5) The business or organization shall use this record only in making the initial employment or engagement decision. Further
dissemination or use of the record is prohibited. A business or organization violating this subsection is subject to a civil action for
damages.
(6) An insurance company shall not require a business or organization to request background information on any employee
before issuing a policy of insurance.
(7) The business and organization shall be immune from civil liability for failure to request background information on an
applicant unless the failure to do so constitutes gross negligence. [1990 c 3 § 1103. Prior: 1989 c 334 § 3; 1989 c 90 §3; 1987 c 486 §
3.] Index, part headings not law-Severability-Effective dates-Application-1990 c 3: See RCW 18.155.900 through 18.155.902.
43.43.836 Disclosure to individual of own record--Fee. An individual may contact the state patrol to ascertain whether that same
individual has a civil adjudication, disciplinary board final decision, or conviction record. The state patrol shall disclose such information,
subject to the fee established under RCW 43.43.838. [1987 c 486 § 4.]
43.43.838 Record checks-Transcript of conviction record, disciplinary board decision, criminal charges, or civil adjudication-
Finding of no evidence, identification document-Immunity-Rules.
(1) After January 1, 1988, and notwithstanding any provision of RCW 43.43.700 through 43.43.810 to the contrary, the state
patrol shall furnish a transcript of the conviction record, disciplinary board final decision and any subsequent criminal charges
associated with the conduct that is the subject of the disciplinary board final decision, or civil adjudication record pertaining to any
person for whom the state patrol or the federal bureau of investigation has a record upon the written request of:
(a) The subject of the inquire;
(b) Any business or organization for the purpose of conducting evaluation under RCW 43.43.832;
(c) The department of social and health services;
(d) Any law enforcement agency, prosecuting authority, or the office of the attorney general; or
(e) the department of social and health services for the purpose of meeting responsibilities set forth in chapter 74.15, 18.51,
18.20, or 72.23 RCW, or any later-enacted statue which purpose is to regulate or license a facility which handles vulnerable adults.
However, access to conviction records pursuant to this subsection (1)(e) does not limit or restrict the ability of the department to obtain
additional information regarding conviction records and pending charges as set forth in RCW 74.15.030(2)(b).
After processing the request, if the conviction record, disciplinary board final decision and any subsequent criminal charges
associated with the conduct that is the subject of the disciplinary board final decision, or adjudication record shows no evidence of a
crime against children or other persons or, in the case of vulnerable adults, no evidence of crimes relating to financial exploitation in
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
which the victim was a vulnerable adult, an identification declaring the showing of no evidence shall be issued within fourteen working
days of the request. Possession of such identification shall satisfy future record check requirements for the applicant for a two-year
period unless the prospective employee is any current school district employee who has applied for a position in another school district.
(2) The state patrol shall by rule establish fees for disseminating records under this section to recipients identified in subsection
(1)(a) and (b) of this section. The state patrol shall also by rule establish fees for disseminating records in the custody of the national
crime information center. The revenue from the fees shall cover, as nearly as practicable, the direct and indirect costs to the state patrol
of disseminating the records; PROVIDED, That no fee shall be charged to a nonprofit organization for the records check: PROVIDED
FURTHER, That in the case of record checks using fingerprints requested by school districts and educational service districts, the state
patrol shall charge only for the incremental costs associated with checking fingerprints in addition to name and date of birth. Record
checks requested by school districts and education service districts using only name and date of birth shall continue to be provided free
of charge.
(3) No employee of the state, employee of a business or organization, or the business or organization is liable for defamation,
invasion of privacy, negligence, or any other claim in connection with any lawful dissemination of information under RCW 43.43.830
through 43.43.840 or 43.43.760.
(4) Before July 26, 1987, the state patrol shall adopt rules and forms to implement this section and to provide for security and
privacy of information disseminated under this section, giving first priority to the criminal justice requirements of this chapter. The rules
may include requirements for users, audits of users, and other procedures to prevent use of civil adjudication record information or
criminal history record information inconsistent with this chapter.
(5) Nothing in RCW 43.43.830 through 43.43.840 shall authorize and employer to make an inquiry not specifically authorized by
this chapter, or be construed to affect the policy of the state declared in chapter 9.96A RCW. {1992 c 159 § 7; 1990 c 3 § 1104. Prior:
1989 c 33 § 4; 1989 c 90 § 4; 1987 c 486 § 5.] Findings-1992 c 159: See not following RCW 28A.400.303. Index, part headings
not law-Severability-Effective dates-Application-1990 c 3: See RCW 18.155.902
43.43.839 Fingerprint identification account. The fingerprint identification account is created in the custody of the state treasurer. All
receipts from incremental charges of fingerprint checks requested by school districts shall be deposited in the account. Receipts for
fingerprint checks by the federal bureau of investigation may also be deposited in the account. Expenditures from the account may be
used only for the cost of record checks. Only the chief of the state patrol or the chief’s designee may authorize expenditures from the
account. The account is subject to allotment procedures under chapter 43.88 RCW. No appropriation is required for expenditures prior
to July 1, 1995. After June 30, 1995, the account shall be subject to appropriation. [1992 c 159 § 8] Findings-1992 c 159: See note
following RCW 28A.400.303
43.43.840 Notification of physical or sexual abuse or exploitation of child or vulnerable adult-Notification of employment
termination because of crimes against persons. (1) The supreme court shall by rule require the courts of the state to notify the state
patrol of any dependency action under *RCW 13.34.030(2)(b), domestic relations action under Title 26 RCW, or protection action under
chapter 74.34 RCW, in which the court makes specific findings of physical abuse or sexual abuse or exploitation of a child or abuse or
financial exploitation of a vulnerable adult.
(2) The department of licensing shall notify the state patrol of any disciplinary board final decision that includes specific findings
of physical abuse or sexual abuse or exploitation of a child or abuse or financial exploitation of a vulnerable adult.
(3) When a business or an organization terminates, fires, dismisses, fails to renew the contract, or permits the resignation of an
employee because of crimes against children or other persons or because of crimes relating to the financial exploitation of a vulnerable
adult, and if that employee is employed in a position requiring a certificate or license issued by a licensing agency such as the state
board of education, the business or organization shall notify the licensing agency of such termination of employment. [1989 c 334 § 5;
1989 c 90 § 5; 1987 c 486 § 6.] Reviser’s note: (1) This section was amended by 1989 c 90 §5 and by 1989 c 334 § 5, each without
reference to the other. Both amendments are incorporated in the publication of this section pursuant to RCW 1.12.025(2). For rule of
construction, see RCW 1.12.025(1)
(2) Dependency actions are undertaken pursuant to RCW 13.34.040
43.43.842 Vulnerable adults-Additional licensing requirements for agencies providing services. (1) the secretary of social and
health services and the secretary of health shall adopt additional requirements for the licensure or relicensure of agencies or facilities
which provide care and treatment to vulnerable adults. These additional requirements shall ensure that any person associated with a
licensed agency or facility having direct contact with a vulnerable adult shall not have been: (a) Convicted of a crime against persons as
defined in RCW 43.43.830, except as provided in this section; (b) convicted of crimes relating to financial exploitation as defined in RCW
43.43.830, except as provided in this section; © found in any disciplinary board final decision to have abused a vulnerable adult under
RCW 43.43.830; or (d) the subject in a protective proceeding under chapter 74.34 RCW.
(2) The rules adopted under this section shall permit the licensee to consider the criminal history of an applicant for employment in
a licensed facility when the applicant has one or more convictions for a past offense and:
(a) The offense was simple assault, assault in the fourth degree, or the same offense as it may be renamed, and three or more
years have passed between the most recent conviction and the date of application for employment;
(b) The offense was prostitution, or the same offense as it may be renamed, and three or more years have passed between the
most recent conviction and the date of application for employment;
(c) The offense was theft in the third degree, or the same offense as it may be renamed, and three or more years have passed
between the most recent conviction and the date of application for employment;
(d) The offense as it may be renamed, and five or more years have passed between the most recent conviction and the date of
application for employment;
(e) The offense was forgery, or the same offense as it may be renamed, and five or more years have passed between the most
recent conviction and the date of application for employment.
The offenses set forth in (a) through (e) of this subsection do not automatically disqualify and applicant from employment by a
licensee. Nothing in this section may be construed to require the employment of any person against a licensee’s judgment.
In consultation with law enforcement personnel, the secretary of social and health services and the secretary of health shall
investigate the conviction record and the protection proceeding record information under chapter 43.43.RCW of each agency or facility
and its staff under their respective jurisdictions seeking licensure or relicensure. The secretaries shall use the information solely for the
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
purpose of determining eligibility for licensure or relicensure. Criminal justice agencies shall provide the secretaries such information as
they may have and that the secretaries may require for such purpose. [1992 c 104 § 1: 1989 c 334 § 11.]
43.43.845 Crimes against children-Notification of conviction or guilty plea of school employee. (1) Upon a guilty plea or
conviction of a person of any felony crime involving the physical neglect of a child under chapter 9A.42 RCW, the physical injury or
death of a child under chapter 9A.32 or 9A.36 RCW (except motor vehicle violations under chapter 46.61 RCW), sexual exploitation of a
child under chapter 9.68A RCW, sexual offenses under chapter 9A.44 RCW where a minor is the victim, promoting prostitution of a
minor under chapter 9A.88 RCW, or the sale or purchase of a minor child under RCW 9A.64.030, the prosecuting attorney shall
determine whether the person holds a certificate or permit issued under chapters 28A.405 and 28A.410 RCW or is employed by a
school district. If the person is employed by a school district or holds a certificate or permit issued under chapters 28A.405 and 28A.410
RCW, the prosecuting attorney shall notify the state patrol of such guilty pleas or convictions.
(2) When the state patrol receives information that a person who has a certificate or permit issued under chapters 28A.405 and
28A.410 RCW or is employed by a school district has pled guilty to or been convicted of one of the felony crimes under subsection (1) of
this section, the state patrol shall immediately transmit that information to the superintendent of public instruction. It shall be the duty of
the superintendent of public instruction to provide this information to the state board of education and the school district employing the
individual who pled guilty or was convicted of the crimes identified in subsection (1) of this section. [1990 c 33 § 577; 1989 c 320 § 6.]
Purpose-Statutory references-Severability-1990 c 33: See RCW 28A.900.100 through 28A.900.102. Severability-1989 c 320:
See note following RCW 28A.410.090.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
STUDENT CONFIDENTIALITY STATEMENT
Student: ___________________________ Program: _________________
(Please print)
Address: _________________
Cell Phone: ____________________ Alternate Phone: _________________
CONFIDENTIALITY STATEMENT: I understand that, as an Allied Health student at Wenatchee Valley College, I am
not considered to be an employee of the clinical agency where I may participate in clinical learning experiences. I
agree to abide by all Wenatchee Valley College policies, procedures, standards, and regulations that guide my
conduct. I understand and agree that in the performance of my duties as a student at Wenatchee Valley College,
I must hold medical information in confidence. Further, I understand that intentional or involuntary violation of
confidentiality may result in punitive action, immediate termination of access to further data, and the immediate
termination of my participation in any clinical learning experience at Wenatchee Valley College.
Signature of Student
Date
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
STUDENT RELEASE FORM
The clinical facilities you will be scheduled in may require copies of your abuse statement, background check and
immunization records. Please sign and return this form to the WVC Allied Health Department as your approval for
releasing this information.
Please know that you have unlimited access to your immunization records. If you are asked by the clinical facility for
your records, please log into complio.com and obtain them.
If requested by the clinical facility to which I have been assigned, you have my permission to release my abuse
statement, background check, and immunization records to that clinical facility.
Name: __________________
Program: _____________
Student Signature: Date: __
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Community Relations / P: 509.682.6420 / F: 509.682.6401 / 1300 Fifth Street / Wenatchee, WA 98801
PHOTO RELEASE
Wenatchee Valley College (WVC) may take and use photographs of me or excerpts of
statements I provided to be used for promotional purposes, such as college publications, the
Web site, displays, video presentations, and advertisements, with the understanding that my
image and statements will be used to promote WVC only. I do this willingly, expecting no
compensation or gratuity of any kind from WVC.
Name: _____________________________________________________________
(Please print legibly)
Address: ___________________________________________________________
Phone: __________________________ E-mail: _________________________
_________________________________________ ___________________
Signature of individual or parent/guardian Date
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
All documentation must be loaded into the American Databank Immunization Tracking System (ITS) (please see
the specific program packet for the directions and package code). Official documentation of immunizations and
program requirements is mandatory. Each immunization record must be on the health care provider’s letterhead,
have the student name, date of immunization, the lot number of the vaccine, and the signature of the person
administering the immunization. All other documentation must be on the provider’s official stationery and have
the student name, date of completion, and provider signature, as necessary.
NOTE: The following immunizations are required for participation in clinical learning experiences. Students WILL
NOT be allowed into the clinical site without current immunizations and requirements loaded into the document
manager.
• Tetanus/Diphtheria/Pertussis (Tdap) Immunization
Students must have had a Tetanus/Diphtheria/ Pertussis injection, or booster, within the last ten (10) years.
The immunization must be a Tdap; Td will not be accepted as the Tdap vaccine. The Tdap includes the
pertussis vaccine that is required. Pertussis protection wears off with time.
• Measles, Mumps, Rubella (MMR) Vaccines, or Titer
Students must provide presumptive evidence of immunity to measles, rubella, and mumps. Presumptive
evidence includes documented administration of two doses of live virus vaccine or positive titers (blood test
for
immunity of Mumps, Rubella, and Rubeola).
• Hepatitis B Vaccines (complete series of three [3] injections)
Students must have the first and second injections prior to entering the Program. Adults getting Hepatitis B
vaccine should get three (3) doses, with the second dose given four (4) weeks after the first and the third dose
five (5) months after the second. Your healthcare provider can tell you about other dosing schedules that
might
be used in certain circumstances. Positive titer (blood test) is acceptable. CDC Guidelines recommend titer
verification after one month of completion of Hepatitis B series.
• Two-Step PPD (Tuberculin Skin Tests)
An initial negative two-step PPD is required, which means that two (2) separate tuberculin skin tests have
been placed one to three weeks apart. Each test is read 48 to 72 hours after it has been placed. This requires
four (4) visits. Documentation must show the dates and results of the tests, as well as the lot numbers of the
vaccine. Students should not get any other vaccination with the first PPD.
Students with a positive PPD must provide documentation of a chest x-ray, treatment (if necessary), and a
release to work in a healthcare setting from a doctor or healthcare provider.
Tuberculin skin tests are required each year (annual renewal) and must be placed and read within one year
following the initial two-step PPD.
As some facilities now utilize the QuantiFERON® TB Gold Test in place of the PPD, WVC will accept this
method. . If the student goes back to the PPD the year after having had the QuantiFERON® TB Fold,
the two-step process is required.
• Chickenpox (Varicella) Immunization
Students must have had two (2) Chickenpox injections or a positive Varicella titer (blood test for immunity).
• Flu Vaccination
Depending on the availability of flu vaccine, students will be required to be vaccinated each Fall Quarter by the
announced date or before December 1, depending on the flu season.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
• Negative Drug Screen
Students must provide results of a standard, ten-panel drug screen, either urine-based or oral swab, dated not
more
than forty-five (45) days prior to the beginning of the Program. If MLT students have their drug screens
anywhere but Confluence Health (formerly Central Washington Hospital), they must have the facility send a copy
of the drug screen report directly to the MLT Program Director. The student must load a copy of the drug screen
report onto the ITS.
• Medical Insurance (pertains to student accidents during clinical experiences)
Clinical affiliates associated with the Allied Health Programs of WVC require that students provide proof of
accident insurance. Students must maintain this coverage for the duration of their attendance, in order to
cover any
accident that might occur while at a clinical site. Even though a clinical facility may provide necessary
emergency
care or first aid for an accident (i.e., needle stick), a clinical facility has no obligation to furnish
medical or surgical
care to any student. The student bears responsibility for the cost of such care, as well as for
any follow-up care.
For students who do not have insurance, WVC recommends the carrier approved by the
Washington State
Board of Community and Technical Colleges. The cost is approximately $45 per quarter. The
student may
enroll online at
https://4studenthealth.relationinsurance.com
• CPR For Healthcare Providers
The CPR card must be issued by a person or facility qualified specifically to instruct CPR for healthcare
providers (i.e., American Heart Association, American Red Cross, Central Washington Hospital [665.6036],
the WVC Health 051 class, and American Safety & Health Institute HealthCare Provider). Online classes are
not acceptable.
Students are required to maintain CPR Certification for Healthcare Providers for the duration of their
attendance, and the card must be renewed
every two years.
• HIV/AIDS Training Certificate
Seven (7) hours of HIV/AIDS training, as required in chapter 246-12 WAC, Part 8, can be obtained by taking
HCA 113 for 1 credit at WVC. An online course is offered through Wild Iris at www.nursingceu.com
. AIDS
education and training must include, but is not limited to, the following: Etiology and epidemiology; testing
and counseling; infection control guidelines; clinical manifestations and treatment; legal and ethical issues, to
include confidentiality; and psychosocial issues, to include special population considerations.
• BACKGROUND CHECKS
Washington State law (RCW 43.43.832) permits businesses or organizations that provide services to children,
vulnerable adults, or developmentally disabled persons to request criminal history records. Facilities used for
clinical
work experience require clearance prior to the student being allowed to work in the facility. Prior to
beginning any
clinical work experience, criminal record checks (Complio®) are required of all students accepted
into the
Allied Health programs at WVC, dated not more than forty-five (45) days prior to the beginning of the
Program. Use the student instructions and package code provided.
Students need to be aware that conviction of certain crimes may prevent completion of the clinical course
requirements of the Program (thereby preventing completion of the Program) and may also prevent future
licensing and employment in the health field.
Wenatchee Valley College Allied Health Packet Revised 06.27.2019
Complio/American Databank:
http://www.wenatcheevalleycompliance.com
Background Check, Drug Screen and document manger packages are required for all allied health programs.
Select one Wenatchee, Omak or other- Your total fee should be $123.00*
*Additional last names and/or choosing “other” could make the total fee be different
If you are in Omak area, choose:
Omak Clinic
916 Koala Ave
Omak WA 98841 (509) 826-1800
Must have paper Chain of Custody Form (form is sent to your mailing address)
Collection Fee - $23.84
Collection M-F 8am-430pm (closed for lunch 12:00-1:30pm & Last check in at 4:30pm) - Walk-in allowed
If you are in Wenatchee area, choose:
Confluence Health Occupational Medicine
317 N. Mission Street Suite 200
Wenatchee Wa. 98801
509.665.5853
Must have paper Chain of Custody Form (form is sent to your mailing address)
Collection Fee - $23.84
Collections M-F 8am-430pm - Walk-in allowed
If you are not in Omak or Wenatchee area and there is a
Quest lab in your area, choose:
Other
If you choose: OTHER- you will be emailed a Chain of Custody form.
Your drug screen will be done at a Quest lab that you choose- they are not in the Omak or Wenatchee area.
COMPLIO questions?
American Databank is always happy to help. You may call, email or message us with any questions or concerns you
have about Complio, your account, or your status.
Email: complio@americandatabank.com
Phone: 1 800 200 0853
Live service: 7am-6pm MT Monday-Friday
