APPLICATION CHECKLIST PLEASE COMPLETE THE FOLLOWING ITEMS IN THE ORDER THEY ARE PRESENTED.

1. Apply to San Juan College and Submit All Official Transcripts

□ Contact the San Juan College Admissions Office for a San Juan College Application for Admission or apply onlineat San Juan College Online Application. Declare your major as AA.LBAS.PTAP on the San Juan CollegeApplication.

□ A current San Juan College student, either non-degree seeking or with a previously-declared major, must complete aStudent Information Update. Declare your major as AA.LBAS.PTAP with the Student Update Form. This link will takeyou to the Enrollment Services Forms page where you can click on Student Information Update. Submit the formto San Juan College Enrollment Services.

2. Contact the Health Sciences Academic Advisor

□ Contact the Health Sciences Academic Advisor, Eileen Salazar, for step-by-step guidance on the prerequisite coursesequence and the PTA application process. If you have attended college previously, she is available to review transcriptsfrom each college and university that you attended and help you determine which prerequisite courses you need totake. Eileen may be contacted at (505) 566-3013 or salazare@sanjuancollege.edu . Her office is located on the San JuanCollege’s main campus in the Health Sciences building.

□ FYEX-1110 - First-Year Seminar - The course is required only for students with less than 24 college credits.This course is designed to help students achieve greater success in college and in life. Students will learn many provenstrategies for creating greater academic, professional, and personal success. Topics may include career exploration,time management, study and test-taking strategies to adapt to different learning environments, interpersonalrelationships, wellness management, financial literacy, and campus and community resources.

3. PTA Program Prerequisites

□ Contact the Health Sciences Academic Advisor, Eileen Salazar, IMMEDIATELY for information specific to thefollowing PTA Program prerequisites.➢ BIOL-1130 – Introductory Anatomy/Physiology -Non-Major AND

BIOL - 1130L - Introductory Anatomy/Physiology Lab – Non-Major

➢ COMM-2120 - Interpersonal Communication➢ ENGL-1110 - Composition I➢ ENGL-1120 – Composition II OR

ENGL-2210 – Professional & Technical Communication➢ HITP-110 – Medical Terminology➢ MATH-1155 – Math for Health Careers OR Higher➢ PSYC-1110 – Introduction to Psychology➢ PTAP-116 – Musculoskeletal Focus for PTAs - (Note: No other class will transfer in for PTAP 116). It must be

taken through SJC the year previous to acceptance in the PTA Program. If you are not accepted in the PTAProgram, you are required to retake PTAP 116 for re-application. Students are only allowed to repeat PTAP116 a maximum of 2 times. Exceptions may be considered per the PTA Program Director’s discretion.

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4. PTA Program Application Materials - Send the following completed PTA Program application materials to thePTA Program. All materials must be received by the PTA Program office before October 1st!

□ Completed PTA Program Application - (Please see pages 7-10 herein for the application.)

□ Completed Letter of Recommendation Forms – (Please send Letter of Recommendation Forms to 3 individualswho can attest to your character and abilities as a prospective physical therapist assistant student. Theseindividuals may be teachers, employers, health care professionals, or others whom you have known in aprofessional capacity. RECOMMENDATIONS FROM FAMILY OR PERSONAL FRIENDS ARE UNACCEPTABLE. Formsmust be sent in a sealed envelope with the recommender’s signature across the seal to the PTA Program. (Pleasesee pages 11-16 herein for forms [i.e. three 2-page forms].)

□ Signed and Notarized Essential Functions form - (Please see 17-18 herein for form.)

□ Results of your ATI TEAS Exam – Please note the window of time that you are able to actually take the ATI TEASends one day before the deadline. (Please see pages 19-24 herein for information.)

□ Completed Clinical Observation Form - (Please see pages 25-28 herein for instructions and form.)

5. Confirmation Contact San Juan College PTA Program at (505) 566-3562 OR (505) 566-3425 to confirm that the

PTA Program has received all application materials BEFORE October 1st!

For questions regarding this Application Checklist, please contact San Juan College PTA Program at pta@sanjuancollege.edu OR (505) 566-3562 / (505) 566-3425.

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ADMISSIONS CRITERIA

Each PTA Program accepts up to 20 students every year. Applicants are ranked based on the following criteria:

Criteria Points Possible

GPA of Prerequisite Courses 65

Admissions Exam Score 20

Letter of Recommendation 5

Letter of Recommendation 5

Letter of Recommendation 5

New Mexico Resident Credit Per SJC Admissions Policy 5

Colorado Resident Credit Must reside in one of the following CO counties: Archuleta, Dolores, La Plata, Montezuma or San Juan.

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Total Points 105

FINANCIAL AID

Financial Aid is available for students who qualify: San Juan College (505) 566-3323Financial Aid 4601 College Blvd. Farmington, NM 87402

PROGRAM COST

Estimated Cost of Prerequisite Courses

In-State Tuition

Out of State Tuition

8 PTA Prerequisites Credits

Resident (includes SJC

Flat & Student Activity

Fees) OR

Non-Resident (includes SJC

Flat Fees)

BIOL-1130/1130L – Introductory Anatomy/Physiology & Lab 4.00 $279.50 or $763.50

COMM-2120 – Interpersonal Communication 3.00 $229.00 or $607.00

ENGL-1110 – Composition I 3.00 $229.00 or $607.00

ENGL-1120 – Composition II OR 3.00 $229.00 or $607.00

ENGL-2210 – Professional & Technical Communication 3.00 $229.00 or $607.00

HITP-110 – Medical Terminology 3.00 $229.00 or $607.00

MATH-1155 – Math for Health Careers OR 3.00 $229.00 or $607.00

MATH-1155A – Health Careers Math w/Skills Review OR 4.00 $279.50 or $763.50

MATH-1215 – Intermediate Algebra OR 4.00 $279.50 or $763.50

MATH-1220 – College Algebra OR HIGHER 3.00 $229.00 or $607.00

PSYC-1110 – Introduction to Psychology 3.00 $229.00 or $607.00

PTAP-116 – Musculoskeletal Focus for PTA 3.00 $229.00 or $607.00

*Total Estimated Cost of Prerequisite Courses @ 26 credit hrs $1,486.00 Or $4,362.00

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The following tables provide a detailed breakdown of the estimated costs associated with each program.

On Campus Program

Semester Tuition (includes SJC Flat & Student Activity Fees)

plus Program Fee plus Textbooks & Additional Expenses

Resident or Non-Resident (Approximate)

Spring Semester $892.00 or $2,496.00 + $150 + $1,379

Summer Semester $488.00 or $1,244.00 + $150 + $177

Fall Semester $942.50 or $2,652.50 + $150 + $74

Spring Semester $892.00 or $2,496.00 + $150 + $0

Totals $3,214.50 or $8,888.50 + $600 + $1,630.00

Online Hybrid Program

Semester Tuition (includes SJC Flat Fees)

plus Program Fee plus Textbooks & Additional Expenses

Resident or Non-Resident (Approximate)

Spring Semester $528 or $1,390 + $250 + $1064

Summer Semester $528 or $1,390 + $250 + $575

Fall Semester $479 or $1,235 + $250 + $307

Spring Semester $528 or $1,390 + $250 + $431

Summer Semester $577 or $1,545 + $250 + $130

Fall Semester $871 or $2,475 + $250 + $0

Totals $3,511.00 or $9,425.00 + $1,500 + $2,507.00

Estimated PTA Program Cost

On-Campus Program Tuition, Fees, Textbooks & Additional Expenses for 4 Semesters

Resident $5,444.50

Non-resident $11,118.50

Online Hybrid Program Tuition, Fees, Textbooks & Additional Expenses for 6 Semesters

Resident $7,518.00

Non-resident $13,432.00

The Estimated Cost of the PTA Program includes tuition, SJC flat fees, technology fees, student activity fees (if applicable), PTA Program fees & expenses, and textbooks for the PTA Program. This estimate does not include the costs associated with prerequisite courses.

*Tuition for residents is $49 per credit hour plus the SJC flat fee for 5 credit hours or more per semester of $185, and a studentactivity fee per credit hour of $1.50 (not to exceed $27.00 per student). Tuition for non-residents is $155 per credit hour plusthe SJC flat fee for 5 credit hours or more per semester of $305, and a student activity fee per credit hour of $1.50 (not to exceed$27.00 per student).

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Miscellaneous Expenses (included in above estimates)

On-Campus and Online Hybrid Programs

Students in both programs are also responsible for annual APTA membership fees, immunizations, PTA student kit ($40), scrubs ($40), drug screening ($25), background check ($74), transportation and lodging on clinical rotations.

Online Hybrid Program Students participating in the Online Hybrid Program are responsible for transportation and lodging associated with the on-campus portion of PTA lab courses. Students are required to be at San Juan College approximately 9-18 days per PTA lab course toward the end of each semester. Online Hybrid students are also responsible for additional fees related to virtual proctoring of PTAP exams through SmarterProctoring and ProctorU.

* SmarterProctoring is a proctoring company that provides identity verification and online proctoring toensure exam integrity. The proctoring involves live, person-to-person, real-time monitoring.SmarterProctoring is required for online hybrid PTAP exams and may be purchased directly through theirwebsite, SmarterProctoring. Prices are subject to change. Additional fees are imposed for exams scheduledless than 72 hours before the appointment. Please see pricing below.

Exam Duration 1-hour session 2-hour session

Pricing (per student per exam) $17.00 $25.00

Upon graduation, the student may have some of the following expenses related to licensure. The fees vary depending on student completion of the recommended exam preparation course and practice exam. Also, the state licensing fee varies depending on the state. All fees related to licensure are the student’s responsibility.

Licensure Expenses

>$500 PTA Licensure Exam Preparation Course (Recommended)

$99 PEAT Exam (PTA Practice Exam & Assessment Tool) (Recommended)

$485 National Physical Therapist Assistant Licensing Exam (FSBPT)

$82.60 Prometric Testing Center Fee (Testing Centers located throughout the United States)

$225 New Mexico Licensing Fee (fees vary by state)

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PTA PROGRAM – APPLICATION FOR ADMISSION

I am applying for the: □ On-Campus Program □ Online Hybrid Program □ Both Programs

(By selecting the “both programs” box, you are indicating that you are willing to relocate if necessary to attend.)

Program Start Date ATI TEAS Exam Windows Application Deadline Decision Date

January 2021 June 10th – 27th, 2020 OR

September 9th – 26th, 2020

October 1, 2020 Mid December 2020

CONTACT INFORMATION Name of Applicant LAST

Preferred Name

FIRST (LEGAL) MIDDLE MAIDEN

Date of Birth San Juan College ID #

Current Address STREET ADDRESS APARTMENT # or PO BOX

CITY STATE ZIP

Permanent Street Address (If different)

STREET ADDRESS APARTMENT # or PO BOX

CITY STATE ZIP

Daytime Phone ( ) Evening Phone ( ) Cell Phone ( )

San Juan College Email Personal Email

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EMERGENCY CONTACT INFORMATION Emergency Contact

NAME RELATIONSHIP TO APPLICANT CITY/STATE

DAYTIME PHONE EVENING PHONE CELL PHONE

EDUCATIONAL BACKGROUND High School Name CITY STATE

GRADUATION DATE GED SCORE

College / University Name

CITY STATE

DATES ATTENDED DEGREE (if applicable) MAJOR (if applicable)

College / University Name

CITY STATE

DATES ATTENDED DEGREE (if applicable) MAJOR (if applicable)

College / University Name

CITY STATE

DATES ATTENDED DEGREE (if applicable) MAJOR (if applicable)

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LEGAL LIMITATIONS

Have you ever been convicted of a felony? □ Yes □ No

(You are not required to answer “Yes” or explain if the criminal adjudication or conviction has been expunged, annulled, pardoned, or otherwise court ordered or legally required to be kept confidential.)

I understand that if I answered “Yes” to the above question, I will need to contact □ Yes □ No

the licensing authority for the state in which I plan to obtain a PTA license to determine if I am eligible for licensure. FSBPT Licensing Authorities Contact Information

I understand that I will be provided with instructions for completing a □ Yes □ No

mandatory background check that is approved by the PTA Program upon acceptance into the program and prior to placement in some clinical externships. All applicants will be responsible for payment.

Have you ever been disciplined for academic or behavioral misconduct by any college □ Yes □ No

or school? Examples of disciplinary action may include, but not limited to: probation, suspension, dismissal or expulsion.

Have you ever previously enrolled in a PT or PTA Program at another institution? □ Yes □ No

If yes, you must list the name of the institution and the program in the explanation box below.

Have you ever had any clinical certification, license or privilege revoked or suspended? □ Yes □ No

If you answered “Yes” to any of the above, please explain.

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ACKNOWLEDGEMENT

Please Initial

I understand that the PTA Program accepts up to 20 students annually into each program ___________ based on a competitive admissions process and that completion of the PTA application or prerequisite courses do not guarantee admission into the program. I must complete all the prerequisite courses with a minimum “C” grade and a minimum 2.75 GPA for my application to be considered by the PTA Program. However, the accepted GPA may be higher than the minimum requirement.

I understand that students may be enrolled in PTAP 116 and other prerequisite courses in ___________ the fall semester. Applicants will be notified of acceptance into the program before winter break once prerequisite grades are provided for all applicants. Both programs start in January of each year.

I understand that if the required application material (Personal Information, 3 Letter of ___________ Recommendation forms, Notarized Essential Functions form (mailed, not emailed or faxed), ATI TEAS results and Clinical Observation Hours form) are not submitted by October 1st, my application will not be considered complete.

I understand that if I elect to take the ATI TEAS exam more than once, my highest score will ___________ be used and verified by the PTA Program Advisor prior to an offer of admission into the PTA Program.

Upon admission into the PTA program, I will be provided with a health examination and ___________ immunization record form, which must be submitted prior to the start of the program or at the discretion of the PTA Program Director. Prior to participating in clinical education, I understand that I must complete all requirements of the clinical facility including, but not limited to, additional immunizations, background checks, and drug screenings.

I understand that I am able to complete clinical rotations at any clinical facility where a clinical ___________ contract can be established and that meets the program requirements outlined in the PTA Program Policies and Procedures.

I certify that the information provided in the application materials is accurate and complete ___________ to the best of my knowledge.

I understand that withholding or providing false information may be grounds for denial of ___________ admission into the PTA Program or expulsion from the PTA Program if admitted.

Signature of Applicant Date

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LETTER OF RECOMMENDATION

Applicant’s Name:

To the Applicant:

I hereby waive my right to access this letter of recommendation. This letter will remain confidential to encourage the recommender to provide a candid assessment. I understand that a personal letter of recommendation from a friend or family member is UNACCEPTABLE.

Signature of Applicant Date

To the Recommender:

The above named person is applying to the Physical Therapist Assistant Program at San Juan College. This letter must be sent in a sealed envelope with a signature across the seal to the PTA Program before October 1st.

How long have you known the applicant?

In what capacity have you known the applicant? NOTE: A friend or family member as a Recommender is UNACCEPTABLE.

Please rank this applicant in relation to others that you have known in a similar capacity.

Generic Abilities* Outstanding Excellent Good Average Poor

Critical Thinking

Communication Skills

Problem-Solving

Interpersonal Skills

Responsibility

Professionalism

Use of Constructive Feedback

Effective Use of Time and Resources

Stress Management

Commitment to Learning * Developed by the Physical Therapy Program, University of Wisconsin-Madison May et al. Journal of Physical Therapy Education.

9:1, Spring 1995.

Please complete both pages. Thank you.

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Please discuss the characteristics that will make the applicant a competitive candidate for the PTA Program at San Juan College. Do not attach additional documentation.

Positive Attributes:

Negative Attributes:

Overall, I rate this applicant as:

□ Outstanding (Top 1%)

□ Excellent (Next 5%)

□ Good (Next 10%)

□ Average (Next 25%)

□ Poor (Next 50%)

□ Unacceptable (Remaining %)

Signature Printed Name Date

( ) Title Organization Phone Number

Street Address PO Box

City State Zip

This Letter of Recommendation must be sent in a sealed envelope with a signature across the seal received by the PTA Program before October 1st. Please mail to:

San Juan College PTA Program Health Science Center #3300 4601 College Blvd. Farmington, NM 87402

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LETTER OF RECOMMENDATION

Applicant’s Name:

I hereby waive my right to access this letter of recommendation. This letter will remain confidential to encourage the recommender to provide a candid assessment. I understand that a personal letter of recommendation from a friend or family member is UNACCEPTABLE.

Signature of Applicant Date

To the Recommender:

The above named person is applying to the Physical Therapist Assistant Program at San Juan College. This letter must be sent in a sealed envelope with a signature across the seal to the PTA Program before October 1st.

How long have you known the applicant?

In what capacity have you known the applicant? NOTE: A friend or family member as a Recommender is UNACCEPTABLE.

Please rank this applicant in relation to others that you have known in a similar capacity.

Generic Abilities* Outstanding Excellent Good Average Poor

Critical Thinking

Communication Skills

Problem-Solving

Interpersonal Skills

Responsibility

Professionalism

Use of Constructive Feedback

Effective Use of Time and Resources

Stress Management

Commitment to Learning * Developed by the Physical Therapy Program, University of Wisconsin-Madison May et al. Journal of Physical Therapy Education.

9:1, Spring 1995.

Please complete both pages. Thank you.

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Please discuss the characteristics that will make the applicant a competitive candidate for the PTA Program at San Juan College. Do not attach additional documentation.

Positive Attributes:

Negative Attributes:

Overall, I rate this applicant as:

□ Outstanding (Top 1%)

□ Excellent (Next 5%)

□ Good (Next 10%)

□ Average (Next 25%)

□ Poor (Next 50%)

□ Unacceptable (Remaining %)

Signature Printed Name Date

( ) Title Organization Phone Number

Street Address PO Box

City State Zip

This Letter of Recommendation must be sent in a sealed envelope with a signature across the seal received by the PTA Program before October 1st. Please mail to:

San Juan College PTA Program Health Science Center #3300 4601 College Blvd. Farmington, NM 87402

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LETTER OF RECOMMENDATION

Applicant’s Name:

To the Applicant:

I hereby waive my right to access this letter of recommendation. This letter will remain confidential to encourage the recommender to provide a candid assessment. I understand that a personal letter of recommendation from a friend or family member is UNACCEPTABLE.

Signature of Applicant Date

To the Recommender:

The above named person is applying to the Physical Therapist Assistant Program at San Juan College. This letter must be sent in a sealed envelope with a signature across the seal to the PTA Program before October 1st.

How long have you known the applicant?

In what capacity have you known the applicant? NOTE: A friend or family member as a Recommender is UNACCEPTABLE.

Please rank this applicant in relation to others that you have known in a similar capacity.

Generic Abilities* Outstanding Excellent Good Average Poor

Critical Thinking

Communication Skills

Problem-Solving

Interpersonal Skills

Responsibility

Professionalism

Use of Constructive Feedback

Effective Use of Time and Resources

Stress Management

Commitment to Learning * Developed by the Physical Therapy Program, University of Wisconsin-Madison May et al. Journal of Physical Therapy Education.

9:1, Spring 1995.

Please complete both pages. Thank you.

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Please discuss the characteristics that will make the applicant a competitive candidate for the PTA Program at San Juan College. Do not attach additional documentation.

Positive Attributes:

Negative Attributes:

Overall, I rate this applicant as:

□ Outstanding (Top 1%)

□ Excellent (Next 5%)

□ Good (Next 10%)

□ Average (Next 25%)

□ Poor (Next 50%)

□ Unacceptable (Remaining %)

Signature Printed Name Date

( ) Title Organization Phone Number

Street Address PO Box

City State Zip

This Letter of Recommendation must be sent in a sealed envelope with a signature across the seal received by the PTA Program before October 1st. Please mail to:

San Juan College PTA Program Health Science Center #3300 4601 College Blvd. Farmington, NM 87402

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San Juan College – Physical Therapist Assistant Program

Essential Functions

Essential functions refer to the fundamental job duties that a person must be able to perform for a given profession. The PTA Program at San Juan College has developed program-related essential functions. Each student must be capable of performing the essential functions outlined herein in order to be accepted into, progress in, and graduate from the PTA program at San Juan College. These standards are necessary to protect students, academic and clinical faculty, other health care personnel, and patients. San Juan College abides by all state and federal nondiscrimination and equal opportunity requirements. With or without reasonable accommodations, the student must independently be able to:

AFFECTIVE DOMAIN

• Demonstrate professional and socially appropriate behavior at all times, remaining flexible and adaptable to

changing conditions

• Display maturity and self-control, even in situations involving stress or conflict

• Act in a punctual, dependable, and responsible manner displaying confidence and a positive attitude

• Maintain personal grooming, hygiene, and dress code consistent with professional expectations

• Adhere to all applicable safety, ethical, and legal standards and procedures

• Exhibit sensitivity to patients’ needs to ensure quality care and emotional support

• Establish cooperative relationships by treating others with fairness and respect verbally and non-verbally,

especially those with different backgrounds

• Uses self-assessment to improve future performance and accepts constructive feedback without defensiveness

COGNITIVE DOMAIN

• Communicate accurately and effectively in English

• Comprehend and carry out complex written and oral instructions given in English

• Learn in an online and traditional classroom format with a grade of C or better

• Discern and utilize relevant information from medical records, professional literature, equipment manuals,

books, and computers to perform duties safely and effectively

• Work under the direction and supervision of the physical therapist following the established plan of care to

achieve the patient goals

• Monitor the patient for changes in response to treatment and communicate necessary information to the

supervising physical therapist and other appropriate personnel

• Exhibit the intellectual problem-solving and critical thinking ability to make effective judgements without

hesitation, especially in treatment

• Implement effective patient care within the expected timeframe dictated by the program and clinical sites

• Follow the contraindications and precautions for the physical therapy interventions used in contemporary

physical therapy practice

• Demonstrate time management skills, attention to detail, and the ability to preplan and prioritize tasks

• Work effectively and efficiently to meet productivity requirements in a fast-paced environment with frequent

disruptions

• Make rapid, effective decisions in urgent or emergency situations while remaining calm

PSYCHOMOTOR DOMAIN

• Stand and walk for at least 8 hours

• Lift, carry, pull, push up to 25 lbs on a consistent basis and 50 lbs occasionally using proper body mechanics

• Reach, crawl, kneel, bend, stoop, and climb

• Possess the bimanual dexterity for palpation, auscultation, manual therapy, wound care, collecting objective

measurements, applying modalities, and manipulating therapeutic equipment and devices

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• Assist patients with bed mobility, wheelchair mobility, transfers, and gait training with or without assistive

devices using appropriate guarding and level of assistance on level surfaces, uneven terrain, curbs, ramps, and

stairs

• Possess adequate strength, endurance, speed, agility, coordination and balance to safely demonstrate and assist

patients with therapeutic exercises

• Type documentation into an electronic medical record system efficiently

• Complete clinical rotations 8 hrs/day, 40 hrs/wk for up to 14 consecutive weeks

• Use visual, auditory, and tactile senses to monitor the patient’s response to treatment

• Detect and respond to monitoring alarms

• Respond quickly to urgent or emergency situations including performing CPR

Essential Functions Acknowledgement Form

I, _______________________________ (student’s printed name), have read and understand this agreement. By signing below, I verify that I am able to meet the essential functions outlined herein. I understand that these essential functions must be performed competently, consistently, efficiently, and safely in order to progress in and graduate from the PTA program. If I am unable to perform these essential functions during the curriculum, then I may not pass the course(s) and may be dismissed from the PTA program at San Juan College.

(Student’s Signature) (Date)

Certificate of Acknowledgement

State of ___________________________________

County of _________________________________

The foregoing document was acknowledged before me, ______________________________________, (printed name of notary public)

this day of ____________________________ by _____________________________________________. (printed name of person acknowledged)

______________________________________________ Notary Public Signature

Affix Official Notary seal.

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ATI TEAS

The ATI TEAS stands for the Test of Essential Academics Skills. The score from this aptitude examination is used in the competitive admissions process to determine acceptance into the PTA Program. The exam may be taken locally through the SJC Testing Center or at an approved testing center near you.

Please contact the San Juan College Testing Center immediately to obtain information on the process to take the Admissions Exam.

San Juan College Testing Center (505) 566-3139Information Technology Center San Juan College Testing Center4601 College Blvd. Room 7120 Farmington, NM 87402

ATI TEAS STUDY GUIDE

Ordering sites are listed below. Make sure you are getting the study guide for the ATI TEAS exam.

• https://atitesting.com/ati_store/product.aspx?zpid=1483 (Suggested)

• http://www.isbnsearch.org/isbn/9781565335752

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Shared Drive/Front Office/ATI Updated 10/16/2019

ATI TEAS Step-by-Step Guide

IMPORTANT – READ CAREFULLY!!

Step 1 Pay the $80.00 exam fee at the SJC Business Office in the Administration Building (Clock Tower Building) or by calling the Business Office at 505-566- 3396. Keep the receipt number. This fee is non-refundable.

Step 2 Create an ATI account at www.atitesting.com for your username and password only. Do NOT schedule or pay with ATI. Bring your username and password to launch the exam on test day.

Step 3 Schedule your appointment online at www.sanjuancollege.edu/test. *Except for Dental Hygiene, schedule at act.org. Please schedule your exam at least 72 hours in advance. The receipt number is required to make an appointment.

Step 4 Read the Rules for Use of the Testing Center carefully so you will know what to expect on the day of your appointment.

Step 5 Check in at the Testing Center, Room 7120D, Information Technology Center, 15 minutes before your scheduled time. Bring government issued photo ID.

Details: Test appointments are scheduled on Wednesday thru Saturday 8:30 AM or

1:00 PM.

$25.00 No Show Fee. Please call at least 24 hours in advance to reschedule your testappointment to avoid the No Show Fee.

ATI TEAS - Students may take the exam once per testing period.

The test appointment will be 3.5 hours in duration.

Program Test Dates 2019 & 2020 Dental Hygiene ACT Entrance Exam 10/26/2019, 12/14/2019, 02/08/2020, 04/11/2020,

06/13/2020 Nursing ATI TEAS 10/30/2019 – 11/16/2019, 01/22/2020 – 02/14/2020 Physical Therapist Assistant ATI TEAS 06/10/2020 – 06/27/2020, 09/09/2020 – 09/26/2020 Respiratory Therapy ATI TEAS Surgical Technology ATI TEAS Occupational Therapy Assistant Program

ATI TEAS 09/25 - 10/19/2019

San Juan College Testing Center Room 7120 Information Technology Center

testingcenter@sanjuancollege.edu (505) 566-3139

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Shared Drive/Front Office/ATI Updated 10/16/2019

Rules for ATI Testing Bring proper identification (such as a driver’s license or a passport) that includes:

o A current photographo Your signatureo A permanent address

Bring your ATI user name and password to launch exam.

Special accommodations due to a disability or medical condition must be arranged inadvance with the Director of Testing and the Disabilities Office. Appropriatedocumentation will be required.

If you are ill or have a fever, please call to reschedule. We do not want to pass along fluor other contagious illnesses. There is a $25.00 no show fee.

If examinees wear excessive perfume, cologne, or other strong smelling lotions/spraysthey could be asked to reschedule the exam.

Only testing candidates are allowed in our testing rooms or waiting areas.

Everything you need for the actual test will be provided. You will NOT be allowed totake any personal items into the testing room.

The ATI exam fee is non-refundable.

Prohibited Items may be stored in one of our lockers.

Testing Candidates may NOT bring the following into the testing room: o purseso books or backpackso cell phones, mp3 players or any other electronic deviceso car key fobo cameraso food, candy, gum, cough drops or beverageso hats, hoodieso watches, digital or analog

San Juan College Testing Center Room 7120, Information Technology Center

(505) 566-3139 www.sanjuancollege.edu/test

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Shared Drive/Front Office/ATI Updated 10/16/19

Guidelines for ATI Off-site Testing Step 1 Locate an official testing center at your local community college or

university to schedule your Off-site testing appointment (ask if they can proctor an internet based exam). Another option is to search the list of testing centers by location at the Consortium of College Testing Centers website.

Step 2 Contact the San Juan College Business Office to pay the $80.00 fee for Off-site testing at 505-566-3396. This fee is non-refundable.

Step 3 Complete the Request for Off-site Proctored Exam form. Include all requested information. Send it to the SJC Testing Center via email at testingcenter@sanjuancollege.edu or via fax at (505) 566-3455. Please schedule the start of your exam during our business hours (Mountain Time) so that we can assist if there are any technical problems. We will work with your testing center to administer this exam. Please note: The Testing Center must receive the completed Request for Off-site Testing five (5) business days prior to your scheduled exam to allow for contact with your testing center.

Step 4 Create an ATI account at www.atitesting.com for your username and password only. Do NOT schedule or pay with ATI. Bring your username and password to launch the exam on test day.

ATI TEASDetails:

The testing appointment will be 3.5 hours. ATI TEAS – Students may take the exam once per testing period, up to

two times per application period.

Program Test Dates 2019 & 2020 *Dental Hygiene *ACT Entrance Exam 10/26/2019, 12/14/2019, 02/08/2020,

04/11/2020, 06/13/2020 Nursing ATI TEAS 10/30/2019 – 11/16/2019, 01/22/2020 – 02/14/

2020 Physical Therapist Assistant

ATI TEAS 06/10/2020 – 06/27/2020, 09/09/2020 – 09/26/2020

Respiratory Therapy ATI TEAS Surgical Technology ATI TEAS Occupational Therapy Assistant Program

ATI TEAS 09/25 – 10/19/2019

*Dental Hygiene ACT Entrance Exam can be scheduled at act.org.

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Shared Drive/Front Office/ATI Updated 10/16/19

Request for Off-site Proctored ATI TEAS Schedule your exam during our business hours:

Tuesday through Saturday, 8:30 AM to 4:30 PM

Fee $80.00 for Off-site testing

Date Paid Receipt Number

Personal information: All fields are required. Last First Middle

Email Address* Birth Date SJC ID # or last 4 digits of SS #

Daytime Phone ( )

Evening Phone ( )

Check the SJC Health Science Program you are applying to: Nursing Physical Therapist Assistant Program Respiratory Therapy Surgical Technology Occupational Therapy Assistant Program

Off-site Testing Center Information Testing Center Name Testing Center phone number

Contact Person Title of Contact

Test Date and time (Mountain Time) Date Time

Email

For SJC Testing Center Staff Email sent: Date/Person Contacted:

Email or fax this form to the San Juan College Testing Center testingcenter@sanjuancollege.edu fax: 505-566-3455

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Shared Drive/Front Office/ATI Updated 10/16/19

Rules for ATI Testing Bring proper identification (such as a driver’s license or a passport) that

includes:o A current photographo Your signatureo A permanent address

Bring your ATI user name and password to launch exam.

Special accommodations due to a disability or medical condition must bearranged in advance with the Director of Testing and the Coordinator ofthe Disabilities Office. Appropriate documentation will be required. Please contact the Testing Center for more information.

If examinees wear excessive perfume, cologne, or other strong smellinglotions/sprays they could be asked to reschedule the exam.

Only testing candidates are allowed in our testing rooms or waitingareas.

Everything you need for the actual test will be provided. You will NOT beallowed to take any materials into the testing room.

The ATI exam fee is non-refundable.

Prohibited Items may be stored in one of our lockers.

Testing Candidates may NOT bring the following into the testing room: o Purses or walletso books or backpackso cell phones, mp3 players or any other electronic deviceso car key fobo cameraso food, candy, gum, cough drops or beverageso hats, hoodieso watches, digital or analogo weapons of any kindo children

San Juan College Testing Center Room 7120, Information Technology Building (505) 566-3139 www.sanjuancollege.edu/test

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CLINICAL OBSERVATION

The required 5 hours of observing licensed PTs or PTAs in clinical practice is intended to help acquaint you with the physical therapy profession. Please complete the information below regarding these Clinical Observation Hours.

GUIDELINES FOR CLINICAL OBSERVATION

1. Call clinical sites in your area. Explain that you are applying to a PTA Program and that you would like toobserve either a PT or a PTA at their facility.

2. Dress appropriately. Follow the professional dress code of the facility. No shorts, jeans, t-shirts, hats sandals,excessive perfume, or body piercings. Slacks, polo shirt, and tennis shoes are acceptable.

3. Be punctual. Make sure that you know who, when, and where you will be meeting. Please call to cancel if youare unable to make the appointment.

4. Maintain confidentiality. Never mention a patient’s name, medical diagnosis, or treatment plan outside of thefacility. This is a HIPAA (Health Insurance Portability and Accountability Act) violation. Do not ask personalquestions about the patient during physical therapy treatment. The PT or PTA may choose to share relevantinformation with you before or after the treatment session.

5. Thank the clinician. Thank the clinician for allowing you to observe their facility. Remember that this isobservation only and that you are not allowed to assist with any treatment due to liability issues.

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CLINICAL OBSERVATION

Applicant’s Name: _________________________________________ Phone Number: ________________________________

All applicants to the PTA Program at San Juan College must complete a minimum of 5 hours of clinical observation or “job shadowing” under the supervision of a physical therapist (PT) or physical therapist assistant (PTA). The purpose of this experience is to give the applicant insight into the physical therapy profession and to help ensure that this career meets the expectations and interests of the applicant. It is the responsibility of the applicant to contact the clinical facilities, schedule the experience, and have the PT/PTA complete this form. The completed clinical observation form must be submitted with the application by the deadline.

Facility Observation Hours PT/PTA Signature

Type Name Date Time In Time Out Hours

Examples

Nursing Home Cedar Ridge Inn 9/15/19 8:00 am 1:00 pm 5.0 Jane Doe, PT

Out-patient Physiotherapy Clinic 10/2/19 10:00 am 12:00 pm 2.0 John Doe, PTA

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CLINICAL OBSERVATION PHYSICAL THERAPY FACILITIES

IN THE FOUR CORNERS AREA

Name of Facility Type of Facility Contact Person Phone Number

ApexNetwork Physical Therapy Out-patient Tim Cousens, PT (505) 488-2615

Cedar Ridge Inn Nursing Home PT Department (505) 324-2130

Northern Navajo Medical Center Hospital PT Department (505) 368-7105

Peak Physical Therapy Out-patient Stephanie Roberts, PT (970) 259-9366

Physical Therapy Sports of New Mexico Out-patient Sid Mosiman, PT (505) 334-9616

San Juan Care and Rehabilitation Center Nursing Home PT Department (505) 325-2910

Special K Fitness Out-patient Jeanette Jaquez, PTA (505) 326-2460

Therapy One Out-patient Greg McManus, PT (505) 326-0064

Three Rivers Physical Therapy Out-patient PT Department (505) 258-4003

Students applying from out of the Farmington area may complete observation hours at any physical therapy clinic that has a PT/PTA.

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