Organization Profile Form

Medical Laboratory Assistant (CMLA) AMT
Organization Profile
Organization Name*
Campus Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
School Type*

High SchoolCommunity CollegeCareer SchoolTechnicalUniversity
High School Affiliate*
Name of Partnered Organization
Current certification agency used (check all that apply)*

AMTASCPNCCTNHANoneOther
Current certification agency used
(if other)
Website Address and/or Academic Program Links*
example: www.amt-university.org
Contact Info
Contact Name*

First NameLast Name
Title*
Business Email*
example@example.com
Phone Number*
Program Curriculum

As indicated in your organization's course catalog
Number of Classroom Clock Hours*
(Convert credit hours to clock hours)
Of those clock hours, how many hours are devoted to the study of fundamental laboratory technology?
(Convert credit hours to clock hours)
Number of Clinical Laboratory Experience Clock Hours*
(Convert credit hours to clock hours)
Attach a copy of your syllabus or course outline*

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Minimum Program Requirements

Check all areas below which apply to your curriculum
Laboratory Safety and Quality
Safety Standards, Infection Control Procedures, and OSHA Regulations

General Knowledge & TerminologyChain of InfectionRegulatory and Standard-Setting AgenciesInfection Control, Isolation Techniques, Aseptic Techniques, & Methods of Disease Prevention PracticesPublic Health Reporting Practices for National & State-Notifiable Diseases (HCV, HIV, lead)OSHA Bloodborne Pathogens Standard and Needle Safety Precaution ActOSHA Hazard Communication Standard PracticesGlobally Harmonized System of Classification and Labeling of Chemicals (GHS)Use of the Material Safety Data Sheets (MSDS)
Quality Assessment, Quality Control, and Confirmatory Testing

Quality Assessment and Quality ControlDeviations from Prescribed Use of Waived TestsConfirmatory and Supplemental Testing
Total Selected - Work Area 1
Pre-Examination (Preanalytical) Considerations
Phlebotomy

General Knowledge & TerminologyPhysiological Aspects of Blood CollectionPerform Capillary Punctures (adult/infant)Prepare Patient for TestsSelect Proper SitesPerform VenipunctureProper Post-Care of SitesProper Tube Draw Sequence for Collecting SpecimensAppropriate Containers for Specimens/Requirements for IdentificationHandle Samples to Maintain Specimen Integrity
Preexamination Processes and Specimen Collection

Instruct patients in the proper collection and preservation of various urine samplesRecognize patient problems related to syncope, nausea, and other complicationsInstruct patients in the collection of other specimens (e.g., semen, feces, sputum)Properly collect and handle specimens with time/temperature requirementsHandle and preserve body fluids for chemical analysisPrepare and stain slides for further analysisProcess specimens for shippingRecognize the suitability of specimens for urinalysis proceduresPrepare, store, and dispose of specimens for test analyses according to standard operating procedureIdentify and report potential preexamination errors (specimen collection, labeling, transporting, and processing)
Total Selected - Work Area 2
Examination (Analytical) Considerations
Chemistry

General Knowledge & TerminologyEndocrinologyHepatic (liver) Function TestsCarbohydrate Metabolism TestElectrolytesKidney Function TestsInstrumentationToxicologyPoint-of-Care and Waived Clinical Chemistry Testing
Hematology

General Knowledge & TerminologyInstrumentationCoagulation and HemostasisPoint-of-Care and Waived Hematological TestingErythrocyte Procedures
Immunology, Serology, and Immunohematology

General Knowledge & TerminologyAnalytic ProceduresSpecial ProceduresSerological Tests for SyphilisPoint-of-Care and Waived Immunological, Serological, and Immunohematological Procedures
Microbiology

General Knowledge & TerminologyMedia, Techniques, and CulturesSpecial Tests
Urinalysis

General Knowledge & TerminologyMicroscopic TechniquesPoint-of-Care and Waived Urinalysis ProceduresGeneral Knowledge of Microscopy
Anatomy and Physiology

Employ Basic TerminologyBasic Knowledge of AnatomyBasic Knowledge of Physiology Systems
Total Selected - Work Area 3
Patient Test Management, Communications, and Foundations
Legal, Ethical, Confidential, and Professional Considerations

Principles of Liability in the LaboratoryUse of Consent FormsGeneral Knowledge of Provider-Performed Microscopy (PPM)Professional Appearance and Ethical Conduct in the Performance of DutiesThe Health Insurance Portability and Accountability Act (HIPAA)American Hospital Association’s Patient’s Bill of Rights and the Patient’s Bill of Rights
Clerical Skills, Communications, and Interpersonal Relations

Chart or File Laboratory-Generated ReportsMaintain Inventory Levels - Order & Restock SuppliesEnter, Retrieve, & Verify Patient Collection Data and Special Notations Using Health Information TechnologyManage Supplies Appropriately Recognizing Test Kit, QC, or Reagent Expiration Date vs. “Open Date” Expiration DateEmploy Billing and Coding for Procedures within the Lboratory Assistant’s Scope of PracticeAcknowledge, Report/Notify, & Document Critical Values AppropriatelyInform Patients of Special Test RequirementsUnderstand the Significance of Critical ValuesDevelop and Use Proper and Professional Verbal & Non-Verbal Communication Skills with Staff, Patients, and FamiliesUse Proper Technique and Etiquette for Answering Phones & Providing Information
Total Selected - Work Area 4
Chemistry

General knowledgeInstrumentationHeptic (liver) function testsCarbohydrate metabolism testEndocrinologyElectrolytesKidney function testsPoint-of-care testing
Hematology

InstrumentationCoagulation and hemostasis
Immunology and serology

General knowledgeSerological tests for syphilisAnalytic proceduresSpecial proceduresImmunohematology
Microbiology

General knowledgeMedia preparation, techniques and culturesSpecial tests
Urinalysis

General knowledgeAnatomy and physiologyAnalytic proceduresMicroscopic techniques
Total Program Requirements Selected
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Medical Laboratory Assistant (CMLA) AMT

Organization Profile

Contact Info

Program Curriculum

Minimum Program Requirements

Laboratory Safety and Quality

Pre-Examination (Preanalytical) Considerations

Examination (Analytical) Considerations

Patient Test Management, Communications, and Foundations