Health Informatics
Program Start-up Request
2014-2015
Name of School District:
District Address:
Name of School where Health Informatics program will be located:
School Address:
Staff Contact Information
Position
Superintendent
Building
Administrator
Supervisor of HI
Program
Health Informatics
Teacher
Science Teacher
English Teacher
Math Teacher
Guidance
Counselor
Technology
Support
Name
Building and Room
Number
School Phone
Cell Phone
Email Address
Please answer the following questions thoughtfully, providing detailed information as requested.
1. Identify the certification of the potential health informatics teacher. IT teachers with a background in the health professions or health
teachers with extensive knowledge of computer technology and programs such as Access are suggested for this program.
2. Describe the personal qualities and work experiences that you believe make this individual the correct person to teach the Health
Informatics program. Be sure to address their computer knowledge and experience with Word, Excel and Access.
3. List the work experiences of the individual hired to teach Health Informatics in the chart below.
Name and
address of
Company
Title of Position
Years Worked at
Company
Duties of the position
If there is more than one Health informatics, provide contact information plus answer questions 1-3 for each teacher.
In addition, a resume may be attached to this RFP if additional information would be helpful to the review committee.
4. Please indicate if your school will be using a Windows or MAC based system in the health informatics computer/classroom.
______ Windows
______ Mac
5. Describe the reliability of your internet service at the school and if you have a technology expert on hand to make sure the computers
used in the Health Informatics program are up and running daily.
6. Submit the school schedule for each semester identifying the time when and in what location the health informatics courses will be
taught.
7. Specify the common planning time for the health informatics, mathematics, science and English language arts teachers to meet and plan
weekly.
8. Describe the methods you will use to recruit students to the program. Please be aware that this program is most successful for students
who can read well, seek out information and make connections among the information they have read to solve complex problems. The
student should have experience in working on the computer.
9. Please identify any issues or concerns that you believe you will need assistance with from the Health Informatics leadership team.
By signing this document we acknowledge all information provided in this document is accurate to the best of our knowledge.
________________________________
______________________________
Superintendent Signature
_______________________________
Date
______________________________
Principal/Director Signature
_______________________________
Date
______________________________
OACTS Executive Director Signature
Due March 15, 2014
Send completed form to:
Date
Thomas N. Applegate, Executive Director
Ohio Association of Career-Technical Superintendents
6628 Wild Rose Lane
Westerville, Ohio 43082
Phone: 614-423-8330
Cell: 512-797-7271
www.ohioacts.org
tomgobucks@gmail.com