Course Information: Phlebotomy Training
Well-trained Phlebotomists are in demand nationwide. Employment opportunities include:
laboratories, blood banks, plasma centers, hospitals, doctor’s offices, and independent clinics just
to name a few. Now you, too, can be part of the medical profession. Learning to draw blood is not as hard as
you may think, and there is NO PRIOR DEGREE, CERTIFICATION, or OTHER COURSEWORK NEEDED to register
for this training.
Course Provider:
This course is provided by Countrywide Phlebotomy (PO Box 3321, Idaho Falls, ID 83401) in partnership with
the Bitterroot College UM. Individuals with specific course content questions should contact Countrywide
Phlebotomy at (208) 589-0132 or learn2drawblood@gmail.com
Course Location:
Bitterroot College Science Lab, Bitterroot College UM, 103 South 9th Street, Hamilton
Course Days and Times:
 6pm-8pm, Friday, June 17, 2016
 9am-3:00pm, Saturday, June 18, 2016
Course Fee & Application:
 Full course payment of $265 and completed application are due by Friday, June 3, 2016 (payment
submission instructions can be found on application page)
 Per Countrywide Phlebotomy policy, no refunds are provided after Friday, June 3, 2016
Course Overview:
Students will be trained in both theory and technique of phlebotomy. You will learn the basic blood draw
methods, which include: Vacutainer, butterfly draws, and finger sticks. All students will be required to
volunteer their arms and fingers for training purposes. However, if you would like to bring volunteers to draw
from, you may do so at 10:30am and 2:30pm on the second day of class. Bringing a volunteer is encouraged as
the more practice you have the more comfortable and successful you will be. Other areas of study include:
basic medical terms, universal precautions, professionalism, and patient’s rights. NOTE: This is an introduction
to phlebotomy procedures and protocols short-course. This class may not meet all the criteria for obtaining
local employment in this field. Some local facilities require additional training to meet internal requirements.
Please contact Chris with Countrywide Phlebotomy at 208.589-0132 for any questions regarding this
information.
Certification:
 Each student is required to attend both course sessions and must complete the skills exam and written
exam with at least 90% accuracy to receive his/her Certification of Completion
Policies:
 For your own safety, please refrain from any alcohol or illegal substance intake within 24 hours prior
to and during this class
 Countrywide Phlebotomy does NOT discriminate against race, religion, gender, or medical history.
However, we may not always be equipped to handle all medical conditions that may apply. Please
notify us of ALL your medical conditions prior to this class.
Course Payment Questions?
Contact the Bitterroot College at (406) 375-0100 or meri1.telin@umontana.edu
Course Content Questions?
Contact Countrywide Phlebotomy at (208) 589-0132 or learn2drawblood@gmail.com
Retain Course Information Sheet for Your Records
5/6/2016
BC-CE- Phlebotomy-Course Information
Course Application: Phlebotomy Training
Application Requirements:
1) Must be 18 years of age by course date (exceptions may be granted,
call (406) 375-0100 for more information)
Application Deadline is Friday, June 3, 2016 for course on June 17 & 18, 2016
Submit completed application to:
Bitterroot College UM
103 South 9th Street, Hamilton, MT 59840
Application questions? (406) 375-0100 or meri1.telin@umontana.edu
Include with completed application:
 Full course payment of $265 (checks payable to Bitterroot College or call (406) 375-0100
to pay with a credit card)
Full Legal Name:
First
Middle
Last
Mailing Address:
City:
State:
Zip Code:
Preferred Telephone:
Email Address:
Date of Birth:
Health History (required)
Do you have any allergies?
Yes
No
Are you currently being treated for any blood disorders?
Yes
No
Are you currently taking any blood thinners or on an aspirin therapy?
Yes
No
Are you currently pregnant?
Yes
No
If so please describe:
Have you EVER been diagnosed with any of the following conditions (please circle all that apply):
Diabetes
Hypoglycemia
Insulin Resistance
Hepatitis
HIV or Aids
Autoimmune Disorders
Breast Cancer
Lymph Node Cancer
Heart Conditions
By signing this application, I certify that the above information is true and correct to the best of my
knowledge and that I have read and understood the accompanying course information material.
Applicant’s Signature*
*or signature of parent or legal guardian in case of age exception
5/6/2016
Date
BC-CE-Phlebotomy-Registration