CrestwoodMedicalCenter

School of Radiology

Application for Admission

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Last Name First MI

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Address

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CityStateZip Code

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Telephone # (please include area code)E-mail Address

Education:

High School(s) attended:

______Dates ______to ______

______Dates ______to ______

Diploma: Yes _____ No _____ GED: _____

College(s)/University(ies) attended:

______Dates ______to ______

______Dates ______to ______

______Dates ______to ______

College/University Degree(s): ______

Application Check List:

  1. Completed application form,_____
  2. Questionnaire,_____
  3. OfficialHigh School transcript,_____
  4. College Diploma_____
  5. Official College transcript,_____
  6. ACT, SAT, equivalent enclosed,_____
  7. Physical examination letter – signed by Physician,_____
  8. Letter of interest,_____
  9. At least 4 letters of recommendation,_____
  10. Documentation of medical/healthcare experience,_____
  11. Application fee._____

All application materials must be received by the School no later than November 15, of each year.

Mission Statement – CrestwoodMedicalCenterSchool of Radiology

“The CrestwoodMedicalCenterSchool of radiology strives to provide a quality educational experience, both clinically and didactically, to its enrolled students. The program is designed to develop the students’, cognitive, psychomotor and affective domains as well as critical thinking and problem solving skills. The end result should be entry level technologists who have developed professional and ethical behaviors and the understanding that growth requires life-long learning.”

The Goals of the Crestwood Medical Center School of Radiology are:

1. “Students will be clinically competent.”

2. “Students will communicate effectively.”

3. “Students will develop and use critical thinking skills.”

4. “Students will develop and use ethical and professional habits.”

Expected Outcomes – CrestwoodMedicalCenterSchool of Radiology

  1. The majority, 75%, of enrolled students will complete the program.
  1. 100% of the students that complete the program will accomplish all required ARRT competencies.
  1. The majority, 75%, of program graduates will pass the ARRT examination on the first attempt.
  1. The majority, 75%, of program graduates will be employed within one year of graduation.
  1. Students and graduates will demonstrate appropriate radiation protection principles as demonstrated by 100% of students passing Radiation Protection class and by an 8.0 or higher on the Radiation Protection section of ARRT examination.
  1. Students and graduates will indicate the program encouraged professional growth as indicated by a 95% positive (yes) response on survey questions.
  1. Students and graduates will be satisfied with their educational experience as indicated by a 95% positive (yes) response on survey questions.
  1. Employers will be satisfied with the graduates’ performance as an entry-level radiographer as indicated by a 95% positive (yes) response on survey questions.

The Crestwood Medical Center School of Radiology prohibits any form of unlawful discrimination on the basis of race, color, religion, sex, age, disability, status as a Vietnam-era disabled veteran or any other characteristic protected by state, federal or local law.

The American Registry of Radiologic Technologists (ARRT) requires all examinees to disclose any prior felony or misdemeanor conviction. If this applies to you, we suggest you contact the ARRT directly at (651) 687-0048 to discuss your specific situation.

The Crestwood Medical Center School of Radiology has fulfilled its obligation to the applicant, student, graduate and profession by informing them of this requirement.

Graduation from the program does not automatically assure the graduate of ARRT

eligibility.

I have read and fully understand the physical standards (as stated on the “General Information Sheet”), required for admission and continuation through the School of Radiology. I can currently comply with the standards as written and I understand that if at any time I cannot fully comply with the standards I will notify School officials immediately. Failure to comply with the physical standards will result in the applicant not being considered and possible dismissal of an enrolled student.

I certify that I have read and fully understand all items on this application and other documents related to the Crestwood Medical Center School of Radiology. I have answered all questions correctly and completely. I understand that incomplete information, the withholding of information or incorrect information may disqualify me for admission into the Crestwood Medical Center School of Radiology or may later be the basis for my withdrawal or dismissal.

Applicant Signature ______Date ______

A NONREFUNDABLE $25 APPLICATION FEE MUST ACCOMPANY THIS FORM.

Make check payable to CrestwoodMedicalCenter.

Please return this application and all materials to:

CrestwoodMedicalCenter

School of Radiology

One Hospital Drive SE

Huntsville, AL35801