<p> PLAB 1323/1023 Phlebotomy Tracking Your Assignments Revised August 19, 2016</p><p>Name ______</p><p>Instructions: Please fill in the “Due Date” and “Date Submitted” for each item listed. IMPORTANT: Keep a copy of your pre-clinical paperwork in your notebook. Class Assignments Due Assignments Type of Assignment Date Date MTS DB Other Completed Email your Instructor x AMA survey (see course Blackboard ‘Announcements’ for link to survey) x Post #1 Post your Introduction to the class. x Post #2 Order of the Draw x Post #3 Capillary Blood Collection x Post #4 Respect the Needle x Post #5 Which Tube Do I Draw? x Post #6 Serum or Plasma? x Post #7 Continuing Education x Read and take Bleeding Edge quiz x Read and take Controlling Blood Culture Contamination Rates quiz. x Complete MTS Introduction to the Clinical Laboratory, make 80% or better on quiz. x Complete MTS Infection Control, make 80% or better on quiz. x Complete MTS Patient Identification, make 80% or better on quiz. x Complete MTS Venipuncture, make 80% or better on quiz. x Complete MTS Skin Puncture, make 80% or better on quiz. x Complete MTS Biosafety, make 80% or better on quiz. x Complete MTS Chemical Safety, make 80% or better on quiz. x Complete MTS Electrical Safety, make 80% or better on quiz. x Complete MTS Fire Safety, make 80% or better on quiz. x Complete MTS Blood Culture, make 80% or better on quiz. x Complete MTS HazCom Standard – GHS Update, make 80% or better on quiz. x</p><p>Due Required Documentation Assignments – to be Uploaded to Castle Branch Date Submitted Date See course Blackboard “Pre-Clinical Modules” button to access information for the following Phase 2: Phlebotomy Technician Student Handbook signature page (1 page) Phase 2: Course Syllabus signature page (1 page) Phase 3: Health Data Form / Physical Exam (1 page) Phase 3: Initial Program Tuberculosis (TB) Test (1 page minimum; additional page(s) of test results may be required) Phase 3: Documentation of Health Insurance (1 page minimum; additional information may be required) Phase 4: ARC Code of Conduct Acknowledgement Form (1 page) Phase 4: ARC Confidentiality and Compliance Acknowledgment Form (1 page) Phase 4: St. David’s Student Orientation Module Post Test Confirmation Page (1 page) Phase 4: St. David’s Statement of Responsibility (1 page) Phase 4: St. David’s Healthcare Student Confidentiality and Security Agreement (3 pages) Phase 4: St. David’s Commitment to Values Statement (1 page) Phase 4: ACC HIPPA Certification (4 pages = 3-page Security Agreement + 1-page post test) Phase 5: Flu Vaccine Record – Fall and Spring semesters only (1 page)</p>