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DIAGNOSTIC MEDICAL SONOGRAPHY PROGRAM APPLICATION (CARDIAC CONCENTRATION)

(FORM A)

NOTE: Applicants must satisfy and fill out requirement #7 OR #8. All applicants must satisfy and fill out requirement #9.

7. If applicable, please provide the following information on your 18-24 month Allied Health Degree Program: Registry/Certificate/License number (examples: RN, RT, PT, LVN, CRT).

Name of Program

Type of Program

Year completed

Registry/License

Verified by

Number

(Office Use Only)

8. If applicable, please provide the following information on your post-secondary education: 60 semester or 90 quarter college credits required with a cumulative 2.75 minimum GPA).

List all colleges attended

Degree

(most recent first)

Earned

Major

Number

of Units

GPA

Year completed / Graduation Date

Verified by

(Office Use Only)

9. Required Coursework: Please provide prerequisite information.

Course work must be college level, completed and documented on an officially sealed transcript and consist of a minimum of 3 semester units or 4.5 quarter units with a grade of “C” or higher. KPSAHS will not accept separately mailed transcripts. Do not list “in progress” courses.

Name of College

Course

Number

Date

Grade

Verified

Number

of Units

Completed

Received

by

Course

(Office Use Only)

  • A.

    Human Anatomy with Lab*

  • B.

    Human Physiology with Lab*

  • C.

    Human Anatomy & Physiology with Lab* (Combined course)

Intermediate Algebra

General Physics**

Written Communication (Comprehension/Composition)

Oral Communication (Speech)

Medical Terminology

  • *

    Anatomy & Physiology must have a lab and cover all major body systems. Students must have completed #A and #B, or #C (combination course).

** Physics must cover heat, sound waves, light, and motion.

Application Cover Sheet, Rev: 12/04, 1/05, 10/05, 9/06, 3/07, 3/08, 9/09, 02/11, 3/11, 6/11

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