Student Health Record Requirements
Phlebotomy Certificate for Healthcare Workers Program
Required Health Records and Submission Deadlines
Due 2 weeks prior to the start of classes
Authorization to Release Information to Fieldwork Sites Form: Read, complete and sign.
Tuberculosis Screening: Two-Step tuberculin skin testing (PPD) or IGRA-serology (T-SPOT or Quantiferon-TB Gold) is acceptable. Results must be dated within 6 months prior to the course start date.
- Two Step Skin Test is 4 Actions:
The first PPD is planted and read (between 48-72 hours).
To rule out a false negative: 7-21 days from the first plant, a second PPD is planted and read (between 48-72 hours).
OR
- IGRA Blood test:
T-SPOT or Quantiferon-TB Gold Note: CDC recommends IGRA for students who are BCG vaccinated
Students with a positive tuberculosis screening: Submit the positive result, a chest x-ray report completed within 12 months of the program start date and a completed Positive Tuberculosis Test Questionnaire Form to the Health and Wellness Center. The questionnaire is required to be completed annually thereafter.
Immunization/Immunity Records:
- tetanus, diphtheria and pertussis (TDaP) – evidence of vaccination within the past 10 years
- hepatitis B – evidence of three vaccinations AND immune titer lab report results (surface antiBODY, anti-HBs)
TITERS: If a titer is drawn, the student is required to submit the lab report to the Health and Wellness Center. Any result that is negative/indeterminate/equivocal will be considered a negative result and the student will be required to be revaccinated with the complete series of vaccinations for which a negative titer is received.
The deadlines for record submission are set by the Office of Workforce Training. Records must be submitted on time. Failure to meet the requirements set above may result in removal from the program. Extensions to deadlines may be granted in certain situations and are dependent upon program regulations. Deadline requests may be made in writing to the Director of Health Compliance but are not guaranteed. Students may be excluded from program participation, including class and lab sessions, until requirements are met.
How to Submit Documentation
Forms, vaccination records, lab and imaging reports may be submitted to the Health and Wellness Center:
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In Person |
Building 19, Room 177 Appointment may be required. |
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Workforce Development Dropbox |
Upload pdf file https://tinyurl.com/yz9rvbnb or complete Electronic Form via links provided |
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Fax |
(413) 755-6045 |
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Release Request |