Organization Profile Form for Medical Assisting
Organization name
*
School type
Career School
Community College
High School
University
Work Force/Apprenticeship
Technical
High school affiliates
(if applicable)
Address
*
Street address
Street address line 2
City
State / Province
Postal / Zip code
Contact name
*
First name
Last name
Title
*
Email
*
example@example.com
Phone Number
*
Accreditor (check all that apply)
*
ABHES
CAAHEP
ACICS
ACCET
ACCSC
Other
Accreditor
(If other)
Current certification agency used (check all that apply)
*
AMT
NHA
AAMA
NCCT
Other
Current certification agency used
(if other)
Number of classroom clock hours as indicated in catalog
*
Number of externship clock hours
*
(Convert credit hours to clock hours)
Minimum program requirements
Check all areas below which apply to your curriculum
General
Anatomy and physiology
Medical law and ethics
Medical terminology
Psychology/human relations (or equivalent)
Clinical
Asepsis/Sterilization/Infection control
First aid CPR
Patient examination and preparation (vital signs, physical exam, patient history, etc.)
Specimen collection and phlebotomy
Pharmacology
Injection
Basic laboratory procedures
Administrative
Basic clerical functions to include: reception, ordering, office safety, etc.
Manual and computerized records management
Financial management and bookkeeping
Insurance (including procedural and diagnostic coding)
Agreement
*
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Submit
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