Admission & Clinical Clearance Document Upload
Upload your admission and clinical-clearance documents securely, then confirm accuracy before submitting.
Student Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Program/Cohort
*
Please Select
Nursing
Medical Assistant
Dental Assistant
Phlebotomy
Radiography
Other
Class Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Document Uploads
Government-Issued Photo ID
*
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
Student Headshot Photo
*
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
Physical Examination / Health Clearance
*
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
TB Clearance / TB Test Documentation
*
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
COVID-19 Documentation if required by the assigned clinical site
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
Live Scan / BCIA 8016 Documentation
*
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
CDPH 283B Nurse Assistant Certification Training Program Application
*
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
Additional Requested Document
Upload a File
Drag and drop files here
Choose a file
Upload a clear PDF, JPG, or PNG. Make sure the entire document is visible and readable.
Cancel
of
Required Acknowledgements
I certify that the information and documents I am submitting are accurate and belong to me.
*
I certify as stated
I understand that unreadable, incomplete, expired, or incorrect documents may delay my clearance and I may be asked to resubmit them.
*
I understand
I understand that submission of documents does not itself mean I am cleared to start class or clinical training; Bell Healthcare Training School will complete a final review and issue a separate Clear-to-Start confirmation.
*
I understand
Securely Submit Documents
Should be Empty: