Organization Profile Form for Patient Care Technician
Organization name
*
School type
Career School
Community College
High School
University
Apprenticeship/Workforce Development
Technical
High school affiliates
(if applicable)
Campus address
*
Street address
Street address line 2
City
State / Province
Postal / Zip code
Contact name
*
First name
Last name
Title
*
Business email
*
example@example.com
Phone Number
*
Website address and/or academic program links
Accreditor (check all that apply)
*
ABHES
CAAHEP
ACICS
ACCET
ACCSC
Other
Accreditor
(If other)
Current certification agency used (check all that apply)
*
AMT
NHA
AMCA
NCCT
None
Other
Certification Agency Used
(If other)
The below list are skills learned in a patient care technician program. Please check the box to indicate that students gain these necessary skills in your program.
Medical terminology, vital signs, blood draws, specimen collections, CPR, daily patient assistance, patient and family education, and patient observation.
Agreement
*
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