HEALTHCARE PROVIDER EDUCATION CENTER
1013 LOGAN AVE.
CHEYENNE, WY. 82001
WWW.HCPEDUCATION.COM
307-778-8861
Welcome and thank you for your interest in this program.
This course is 3 weeks in length Monday to Friday 8:00 – 4:00 pm
Cost
$425.00 All fees are nonrefundable
Must be paid prior or day of registration in the form of money order, cash, or cashiers check paid
to Shirlene Lojka
2012
Dates of classes – please circle your choice
January 9th–27th
February 13th–March 2nd
March 19th-April 6th
April 23rd–May 11th
May 28th-June 15th
July 9th-July 27th
August 13th-31st
September 17th- October 5th
October 22nd- November 9th
January 7th- January 25th 2013
MANDATORY REGISTRATION TUESDAY the week before scheduled class between the
hours of 1PM and 4PM. Please being your social security card and driver’s license, or passport,
or birth certificate.
Completed application and notarized section must be submitted prior to the start of class.
Returned forms are not a guaranteed admission into the program. You may drop or mail
completed forms to above address.
Attendance
Attendance is expected at all classroom and clinical experiences.
Quizzes and Final
An 80% or greater must be obtained on each quiz and final in order to continue the course.
Dress Code
Classroom attire will be comfortable street clothes. Pajamas and slippers are not considered
appropriate attire and will not be tolerated. You will be instructed to change clothes. Time away
from class will be made up at instructor’s discretion.
Clinical dress code
Nursing scrubs of any color or pattern is approved.
Shoes must be closed toe, nonskid, good support tennis shoes or nursing shoes.
Hair must up off the shoulders; pony tail is not acceptable.
Nails must be short. No bright nail polish. No acrylic nails are allowed.
No perfumes or colognes.
Other required clinical supplies
A watch with a second hand or digital.
Small note book and black ink pen.
Confidentiality is essential in the healthcare field. Topics discussed in class or clinicals must not
be repeated outside of the healthcare facility or classroom. This will be discussed in more detail
throughout the course.
Please come prepared for discussion and demonstration, the individual success depends on each
students desire to learn, it is up to you to succeed.
The state health department requires that all students must receive a tuberculin skin test before
clinicals. I will administer the tuberculin skin test on the second Tuesday of class, if you are
pregnant, have an upper respiratory infection, or have had a positive skin test in the past you
must provide a written statement from your physician before clinicals. If you have received a
tuberculin skin test in the last 12 months a copy must be submitted to your clinical instructor.
CPR
It is mandatory that all CNA students complete a Healthcare Provider CPR course. A CPR
course is scheduled during this program. If you have already received Healthcare Provider CPR
training you must submit a copy of your card to instructor before clinicals. If you cannot show
required card you will not be allowed to participate in clinicals. Clinicals are a mandatory part of
the course and failure to complete them is reason for immediate expulsion from the program.
This is my business and will be treated as any other business, in signing this contract the student
agrees to all the terms listed. Fees for the program must be paid when specified. This legal and
binding contract will need to be notarized before registration day.
Return this notarized portion and application
________________________________
__________________________________
Print name
Signature
Subscribe and sworn before me on this _________________ day of____________________, 20_______
________________________________________________
Notary