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Phlebotomy Enrollment Agreement 
To enroll in Blessings Healthcare Career Academy's Phlebotomy Program please fill out the form below, click the submit button at the end,
and then fill out the Phlebotomy Enrollment Form

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Phlebotomy Enrollment Agreement

PROGRAM INFORMATION

PROGRAM / COURSE NAME: Phlebotomy Technician

Description Of Program / Course:
This course is composed of 120 hours of instruction in which 80 hours are classroom and 40 hours are lab practicum. This program is designed to provide students with the knowledge and skills that are required to become a CNA Phlebotomy Technician. The
Phlebotomy Technician program educates students to collect, process and properly transport laboratory specimens, correctly lab specimens, identify pre-analytical errors, and clinical procedures under the supervision of a Physician or Nurse Practitioner. Phlebotomy Technicians typically work in conjunction with clinical laboratory personnel and other 
healthcare providers in clinics or other healthcare facilities. They also may work within the hospital, private physician offices, etc. Through classroom work and skills lab training, students learn to collect blood specimens by venipuncture, finger sticks, heel sticks, perform vision and hearing screening, etc. Students do not need to leave the school and attend any other location for this portion of the course. The end of the course includes lab practicum which will occur in the lab during normal class hours. Upon successful completion, students are prepared to sit for the Association (NHA), National Certification Exam to become a Certified Phlebotomy Technician (CPT). The National Healthcareer Association (NHA). Certification is not required for employment; however it is highly recommended.

A certificate of completion is provided at the end of the course. Upon successful completion
of the Phlebotomy Technician program, students will be able to obtain jobs as a Certified
Phlebotomy Technician in the following areas:
● Hospitals
● Private practices and clinics
● American Red Cross
● Nursing homes
● VA clinics/hospitals
● Urgent care or emergency clinics
● Mobile phlebotomy
● Paramedical examiners
● Health fairs

Copyright 2022 All Rights reserved: The CNA Instructor Consultants LLC.

Performance Objectives:
● Prepare students for success in a healthcare career path leading to post-secondary
programs that license healthcare professionals.
● Ability to complete blood draws and specimen collections safely.
● Uphold the honor and high principles of the profession and accept its disciplines.
● Develop attitudes consistent with those expected of an individual working in the
healthcare industry and society in general.
● Demonstrate the knowledge, skills, and professionalism required by employers and
patients.
● Identify common clinical procedures performed in the medical office.
● Demonstrate knowledge of the systematic examination of patients.
● Apply administrative principles in the medical office setting.
● Demonstrate knowledge of EMR, office accounting, and medical law/ethics to work in
an office.
● Apply for and pass the Certification Exam through National Healthcareer
Association (NHA).
Requirements For Admission:
● Enrollment Agreement
● High School Diploma or GED
● Government Issued ID
● Social Security Card
● Proof of Hep B Vaccination

(THE FOLLOWING AREA LOOKS LIKE IT IS MEANT TO BE FILLED OUT BY THE ACADEMY)

PROGRAM START DATE: ________ SCHEDULED END DATE: ____________

FULL-TIME ⬜ PART-TIME ⬜ DAY ⬜ EVENING ⬜


DAYS/EVENINGS CLASS MEETS: (circle) M T W Th F Sa Su

TIME CLASS BEGINS: __________ TIME CLASS ENDS: __________

NUMBER OF WEEKS: _____

TOTAL CREDIT or CLOCK HOURS: ___________

CONSUMER INFORMATION
This is a new Phlebotomy Technician Program was not in operation this year or the 2022-2023 school year, therefore there currently are no statistics surrounding our pass rates, enrollment numbers, re-enrollment number, student transfers, state exam attempts, pass rates, employment rates, or average salary of past students.

FINANCIAL AID
We do not offer financial aid assistance.

TUITION & FEES

● Textbooks: $100
● Workbook: $50
● Student ID card: $50
● Registration Fee: $150
● Practical Lab fee: $550
● CPR certification: $65
● National Exam fee: $85
● Criminal background check: $55
● 120 Hours of Phlebotomy Instruction: $1,395
● Total: $2500

COURSE HOURS


Day Class:

Day Class Monday- Thursday Class 8:30 am-1:45 pm

Clinical Days- Monday -Thursday 7am- 6:00 pm ( four 10 hour days, week 4, week 5 or week 6)

 

REFUND / CANCELLATION POLICY

 

The following policy refers to when a student’s enrollment is terminated or should the students decide to withdraw. If a student decides they no longer wish to proceed with the Phlebotomy Technician Program prior to the first day of class, they may withdraw with no penalties and all tuition monies refunded. Application fee of $150 is non-refundable. The student must withdraw formally via a withdrawal request form given to the administrator or program coordinator and it must occur prior to the first day of class and NOT the same day as the first day of class.

Withdraw Procedure: Withdrawing from the school may have both academic and financial aid consequences. You are encouraged to understand the consequences before you decide to withdraw.


Any student that would like to withdraw after the first day of class must submit a formal withdrawal request form to the program coordinator. The student's request will be evaluated upon receipt. Once students enroll in the program they have until the 3rd day of class to decide if they would like to withdraw with a full refund minus $150 to cover any administrative costs.
 

Any student that submits a withdrawal request form after the 3rd day of class will be subject to a refund of 75% refund at 25% of the course completion or 50% refund at 50% of course completion. Students who withdraw after 50% of program attendance will not receive a refund.


Any student that is terminated from the program will be refunded based on the refund scale above. All refunds will be processed and sent out by check via US mail to the student within 2 weeks of withdrawal request.

Complaint Policy: Student complaints are defined as any student concern regarding the school programs, services or staff. A student who has a concern about a school-related issue is encouraged to submit a grievance form to the program coordinator for resolution as soon as possible. The program coordinator will schedule a meeting with all involved parties within 48 business hours of student filing. If needed an investigation will be conducted by the administrator and program coordinator with final finding to be delivered to the student within 5 business days of the student initial complaint filing. If students are not satisfied with the schools final decision on the grievance, the student may file an appeal. COMPLAINTS AGAINST THIS SCHOOL MAY BE REGISTERED WITH THE BOARD OF HIGHER EDUCATION". If the student would like to further pursue a complaint, they may contact the Illinois Board of Higher Education to file an online complaint at http://complaints.ibhe.org/ Students may also contact the IBHE, Illinois Board of Higher Education,
1 N. Old State Capitol Plaza, Suite 333, Springfield, IL 62701
at (217) 782-2551 if they choose.

Passing Criteria: To pass the classroom instruction of the course, the student must maintain an average of 70% or above on all tests. Students below 70% or a ‘B’ will need remediation. Assistance from the instructor will be available if necessary.

GRADING SCALE
Grade %
A 100-90
B 89-80
C 79-70
D 69-60
F 59 or below

Lab: Lab is based on a pass/fail scale. A student must have an overall grade of Pass in order to be considered successful and pass the lab portion of the course. During lab, a student will have TWO attempts to display competency in a skill (skills check off) after being taught that skill and demonstrated that skill. The student will have open lab time to practice each skill before skills check off. Any student that does not display competency after the third attempt of skills check off will not pass the lab portion of the course and will be removed from the program without a refund.


Tardiness and Absenteeism: Students more than 15 minutes late to class are considered late. If a student is late 3 times, it will be considered an absence. Due to the short nature of this course and its condensed content, students are only allowed one absence during lab or theory portion of the entire course. If a student misses one day of lab or theory or is late 3 times, the student MUST make up that theory or lab day on the pre-designated make-up day which is noted on the Master Schedule and discussed on the first day of class. There are no other offered make-up days and there are no exceptions. If a student misses more than 1 day of class, they will be removed from the course without a refund.


Students are expected to make every clinical day as there are only five of them and students are made aware of the clinical days well in advance. If a student misses clinical there is no make-up day for clinical during their class offering. The student must wait until the next
scheduled clinical rotation day offered by the school for the next class offering. Classes are offered every 6 weeks. The student must note that if the class offering is not in session due to
 low or no enrollment, or if the class is too full, they may need to wait until the next course/clinical offering. Students MUST take the next offered clinical rotation offered by the school and cannot choose from dates that they prefer. Students will not have to wait any longer than 12 weeks to finish the missed/ final clinical day. There is no fee for this make up day.
 

If a student misses a day of class, it is up to them to contact the instructor and make the proper arrangements. Excessive tardiness, excessive lateness or excessively leaving class early will result in student termination from the program with no refund.

 

Student behaviors: If students choose not to participate in appropriate behaviors, they will be terminated from the program. Unacceptable behaviors include but are not limited to:


No smoking while on school or clinical premises, no cell phone usage while in class, lab or the clinical area, horse play or unsafe behaviors in the clinical, lab or classroom, uniforms that are dirty, wrinkled, or not school issues, shoes that dirty, no artificial nails, no perfumes or colognes, no disrespectful talk or offensive behavior.


Students should limit jewelry, non-dangling, hair neat and pulled back from face, protect resident privacy, comply with HIPAA, respond to emergencies, report evidence of resident neglect, and must wear school issued ID badge at all times.

Graduation: Students who complete all areas of instruction with a passing grade will be provided with a certificate of completion and submitted to the state as eligible to sit for the state certification exam.

NOTICE TO STUDENT

1. Do not sign this agreement before you have read it or if it contains any blank spaces.


2. This agreement is a legally binding instrument and is only binding when the agreement is accepted, signed, and dated by the authorized official of the school or the admissions officer at the school’s principal place of business. Read all pages of this contract before signing.


3. You are entitled to an exact copy of the agreement and any disclosure pages you sign.


4. This agreement and the school catalog constitute the entire agreement between the student and the school.

 

5. Any changes in this agreement must be made in writing and shall not be binding on either the student or the school unless such changes have been approved in writing by the authorized official of the school and by the student or the student’s parent or guardian. All terms and conditions of the agreement are not subject to amendment or modification by oral agreement.


6. The school does not guarantee the transferability of credits to another school, college, or university. Credits or coursework are not likely to transfer; any decision on the comparability, appropriateness, and applicability of credit and whether credit should be accepted is the decision of the receiving institution.

 

STUDENT ACKNOWLEDGMENTS

1. I hereby acknowledge receipt of the school’s catalog, which contains information describing programs offered, and equipment or supplies provided. The school catalog is included as part of this enrollment agreement, and I acknowledge that I have received a copy of this catalog.


2. I have carefully read and received an exact copy of this enrollment agreement.

3. I understand that the school may terminate my enrollment if I fail to comply with attendance, academic, and financial requirements or if I fail to abide by established standards of conduct, as outlined in the school catalog. While enrolled in the school, Iunderstand that I must maintain satisfactory academic progress as described in the school catalog and that my financial obligation to the school must be paid in full before a certificate or credential may be awarded.

4. I hereby acknowledge that the school has made available to me all required disclosure information listed under the Consumer Information section of this Enrollment Agreement.

5. I understand that the school does not guarantee transferability of credit and that in most cases, credits or coursework are not likely to transfer to another institution. In cases where transferability is guaranteed, [school name] must provide me with copies of transfer agreements that name the exact institution(s) and include agreement details and limitations.

6. I understand that the school does not guarantee job placement to graduates upon program completion.

7. I understand that complaints, which cannot be resolved by direct negotiation with the school in accordance with its written grievance policy, may be filed with the Illinois Board of Higher Education, 1 N. Old State Capitol Plaza, Suite 333, Springfield, IL 62701 or at www.ibhe.org.

The student acknowledges receiving a copy of this completed agreement, the school catalog, and written confirmation of acceptance prior to signing this contract. The student by signing this contract acknowledges that he/she has read this contract, understands the terms and conditions, and agrees to the conditions outlined in this contract. It is further understood that this agreement supersedes all prior or contemporaneous verbal or written agreements and may not be modified without the written agreement of the student and the School Official. The student and the school will retain a copy of this agreement.

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