Hill College
Health Science
EMT-Basic
Course Requirements
EMSP 1501
EMSP 1160
Spring 2014

Prior to Summer Enrollment the EMT-Basic candidate must have completed the following:
o Completed the Hill College General Admission Application. www.hillcollege.edu
o Completed the attached EMT-Basic student information documents.
o Prospective students must contact the Health Science EMSP Department for Registration/Advising.
o Student must bring to the first class day the required textbooks, uniforms and essential supplies (See
attached Prospective Student program requirements check list)
o Submit immunization documents and/or serological blood test (titer) for immunity.
o Submit current CPR- American Heart Association – Health Care Provider - Basic Life Support with
Hands on Didactic
o Documentation of current Major Medical Insurance
o 11 panel drug test – must be submitted June 13, 2014:
The preferred testing site is:
realPerformance (formerly Cleburne Physical Therapy) 1014 N. Nolan River Road Cleburne,
TX 76033 Phone: 817-641-8617 ~ $42.00 ***all other sites must be pre-approved by EMS
Professions Coordinator/Director.
All documents submitted must be legible – any documents that are not legible will be returned to the student and must
be resubmitted.
EMT-Basic students can be conditionally enrolled in the EMTBasic program while completing the immunization requirements.
Students who do not meet the mandatory immunization
requirements prior to the scheduled clinical rotations will be
dismissed from the program.
EMT-Basic Information packet
July 2013
Hill College Health Sciences
Emergency Medical Services Professions
Student Conditional Enrollment
Immunizations/Drug testing
I, ___________________________________________, acknowledge that my Spring 2014
registration/enrollment in the Hill College Emergency Medical Services Professions EMT-Basic course is
conditional. This conditional enrollment is contingent on completion of the mandatory immunization
requirements by 4pm February 10, 2014. Failure to complete these requirements could result in dismissal
from the program.
*Hepatitis B Series (3 shot series)
Hep B #1 and #2 must be completed before 4pm February 10, 2014
Tetanus (within last 7 years)
Tdap (within adult lifetime)
TB Test (within last 6 months)
*2 MMR (measles, mumps, rubella)
*Varicella (vaccine (2 boosters) or titer immunity)
Seasonal Influenza
Current Major Medical Insurance
Criminal Background process completed
*students who cannot find their original immunization records can have a Serological Titer drawn to
determine their immunization.
●I acknowledge that I must submit receipt of completing a drug test by January 13, 2014.
●I acknowledge that if I do not complete the immunization requirements by 4pm February 10, 2014 I will
be placed on clinical probation.
●I acknowledge that if I fail to meet the terms of the clinical probation will result in dismissal from the
Emergency Medical Services Professions program.
 I further acknowledge understanding that the last day to drop with a “W” for the Spring 2014semester is
April 11, 2014.
___________________________________________________
Signature
EMT-Basic Information packet
_________________________
Date
July 2013
Hill College
Emergency Medical Services Professions
EMT Basic Prospective Student Requirements
__________ 1. Apply to College/Update current application and Follow College Enrollment Process.
__________ 2. Seek EMS Professions Coordinator/Director for advisement for specialized enrollment in EMSP.
__________ 3. Select & register for desired course(s) (pay for classes upfront, make payment arrangements, or
contact the Financial Aid office) (tuition/fees according to Hill College semester hour schedule).
__________ 4. Course completion of AHA Healthcare Provider course (2010 ECC Guidelines)
(contact EMS Professions Coordinator if you need this course)
__________ 5. Complete Background Check at http://student.verifiedcredentials.com/?organization=hillcollege
Code: BBKPC-26727
__________ 6. Obtain required textbooks for courses chosen
EMT-Basic: Prehospital Emergency Care 9th Edition Mistovich ISBN 9780137067961
__________ 7. Obtain 2 uniforms for level of training selected.
EMT-Basic: 2 Blue uniform shirts, 2 navy or black EMS style or Dickies pants, Solid black
shoes/boots, black belt, 2 Hill College EMT undershirts, a watch with a second hand/second counter,
and 2 Hill College EMS Patches. (patches & undershirts at campus bookstore)
**Uniforms may be purchased at the following or at a location of your choice:
Unique Scrubs-N-More
George Wood Clothing, Inc.
200 S. Ridgeway
120 Riverside Drive
Cleburne
Fort Worth
817-641-7878
817-834-8031
__________ 8. Obtain required course supplies: stethoscope, BP cuff, pen light, 4X6 cards, trauma shears, 3” 3 ring
binder, paper/notebook, pens/pencils ( purchased at your location of choice)
__________ 9. 11 Panel Drug Test
The preferred testing site is: realPerformance (former Cleburne Physical Therapy) 1014 N.
Nolan River Road Cleburne, TX 76033 Phone: 817-641-8617 ~$42.00 ***all other sites must be
pre-approved by EMS Professions Coordinator
January 13, 2014
***Receipt of DRUG TEST MUST BE Submitted BY
***
_________ 10. Get copies of shot/immunization records or update any that are out of date (or a titer showing
immunity)
Hepatitis B Series
Tetanus (within last 7 years)
Tdap (within adult lifetime)
TB Test (within last 6 months)
2 MMR (measles, mumps, rubella)
Varicella (vaccine (2 boosters) or titer immunity)
Seasonal Influenza
Meningitis (ages 17-30 for incoming freshman)
***Immunizations NEED TO BE COMPLETED/UPDATED BY 4pm February 10, 2014***
_________ 11. Need a copy of your current major medical insurance.
WELCOME TO HILL COLLEGE EMS PROFESSIONS!
EMS Professions Coordinator/Director:
Diedra R. Blankenship, LP, EMSAC, BSEHS2112 Mayfield Pkwy Cleburne, TX 76033 ●
(817) 760-5929 FAX: (817) 760-5930
dblankenship@hillcollege.edu
EMT-Basic Information packet
July 2013
Hill College Health Sciences
Emergency Medical Services Professions
EMT-Basic
Student Information Sheet
Spring 2014
Full Legal Name: _________________________________________________________________________________
Mailing Address: ____________________________________________City ___________________Zip ___________
Email Address: ____________________________________________________
Telephone Number(s) Home_____________________________ Other______________________________
Hill College Student ID#:_____________________________________________________________
The name and state of *high school attended__________________________________________________
Grade completed (circle only one) 1 2 3 4 GED
*Submit official high school transcript or GED scores to the Health Science department.
List below any licenses/certifications or health-related credentials you currently hold. You must submit all supporting
documents to the Health Science Department.
____________________________________________________________________________________
Please list all colleges attended as well submit all official college transcript for each college attended to the Health
Science Department.
1. ___________________________________________________________________________________
2. ___________________________________________________________________________________
Signature: ________________________________
EMT-Basic Information packet
Date: __________________________
July 2013
Emergency Medical Services Professions
Criminal Background Statement
I, _______________________________________________, acknowledge that I will be required to have a
criminal background check and an 11 panel drug test completed before I can register for any Hill College
Health Science Program.
I acknowledge that clinical facilities have the right to refuse any student to attend clinical rotations at their
facility for any issue related to an eligibility issue. If this occurs, the student will not be able to continue in
the Emergency Medical Services Professions program.
Texas Department of State Health Services (TDSHS) Occupation Code, Chapter 53
§ 53.021. Authority to Revoke, Suspend, or Deny License
(a) A licensing authority may suspend or revoke a license, disqualify a person from receiving a
license, or deny to a person the opportunity to take a licensing examination on the grounds
that the person has been convicted of a felony or misdemeanor that directly relates to the
duties and responsibilities of the licensed occupation.
(b) A license holders’ license shall be revoked on the holder’s imprisonment following a felony
conviction, felony community supervision revocation, revocation of parole, or revocation of
mandatory supervision.
http://www.dshs.state.tx.us/emstraumasystems/qichapter53.shtm
__________________________________________
Signature
EMT-Basic Information packet
_____________________
Date
July 2013
Hill College
Health Science
Drug Testing Statement
I, ________________________________________________, acknowledge that I will be required to
submit a negative drug test on January 13, 2014, for the following controlled substances:

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Amphetamines
Barbiturates
Benzodiazepines
Cocaine Metabolites
Marijuana
Methadone
Methaqualone
Opiates
Oxycodones
Phencyclidine
Propoxyphene
I further acknowledge that if I present a positive drug test I will not be able to continue the Hill College
Health Science EMT-Basic Program. If currently enrolled I acknowledge that I could be randomly drug
tested if a member of the Hill College Health Science department suspects that I am under the influence of a
controlled substance. If I refuse to submit to the requested drug test I will be dismissed from the program.
_____________________________________
Signature
EMT-Basic Information packet
________________________
Date
July 2013
Hill College
Health Science
EMT B Class cost
Below is an estimated price list of the cost for the EMT B class. These prices are subject to change,
uniforms, misc supply prices vary widely depending on how many and quality of product…for example:
Stethoscope prices can range between $12.00 – $350.00 depending on brand.
Tuition ....................................................................................................................... $650-1000.00
Background Check .................................................................................................... $51
Drug Test .................................................................................................................. $42
Preferred drug testing site: realPerformance – see drug testing memo included in packet.
Uniforms ................................................................................................................... $200
See EMT Basic Prospective Student Requirements page in packet.
Misc. Supplies .......................................................................................................... $150
Books ........................................................................................................................ $150-250
paid directly to Hill College Bookstore
National Registry ....................................................................................................... $76
(for each attempt) – paid straight to National Registry
State Certification ..................................................................................................... $70-100
Fingerprinting for State Certificate .......................................................................... $10-50
For further clarification on the State Certificate fee and fingerprinting requirements please follow the
link http://www.dshs.state.tx.us/emstraumasystems/
Cost for the immunizations is dependent on what records the student has, what immunizations are still
needed and the cost associated with each missing immunizations.
EMT-Basic Information packet
July 2013
Hill College
Health Science
Essential Clinical Performance Standards
The Hill College Health Science Department has developed the following essential performance standards which Hill
College Health Science students are expected to possess and demonstrate. These standards are based upon
required abilities that are compatible with effective performance in health careers and are intended to help
potential students make career decisions. Health Science students unable to meet the essential performance
standards are responsible for discussing the possibility of reasonable accommodations with the program coordinator
before starting clinical and providing medical and other documentation related to any disability and the appropriate
accommodations needed to meet the standards. Reasonable accommodation for students with disability-related
needs will be determined on an individual basis, taking into consideration the standards and essential skills which
must be performed to meet program objectives as well as personal and client dignity and safety.
The Health Science Department Student:
1. Has visual acuity with corrective lenses to:
a. accurately read small print on medication containers, syringes, discriminate color changes, read type at 8
font, and hand-writing on college ruled paper
b. see objects up to 20 inches away
c. accurately read monitors and equipment calibrations
d. identify call lights and unusual occurrences on a unit at a distance of 100 feet.
2. Has sufficient auditory perception with corrective devices to:
a. hear monitor alarms, emergency signals, client’s call bells, pagers, and telephone conversation
b. hear client’s heart sounds, bowel sounds, and lung sounds with a stethoscope
c. receive and understand verbal communication from others
d. distinguish sounds with background noise ranging from conversation levels to high pitched sounding alarms.
3. Has the physical ability and stamina to:
a. perform client care for an entire length of clinical experience, 24 hours.
b. stand for prolonged periods of time, 8-12 hours.
c. transfer/position/lift up to 150 lbs with assistance
d. lift and carry objects (up to 150 lbs) with assistance
e. push/pull equipment requiring force on linoleum and carpeted floor
f. stoop, bend, squat, reach overhead while maintaining balance as required to reach equipment, supplies, and
perform client care, including cardiopulmonary resuscitation (CPR)
g. manipulate equipment through doorways and into close fitting areas.
4. Has the manual dexterity including sufficient gross motor and fine motor coordination to:
a. pick up, grasp, and manipulate small objects with control
b. perform electronic documentation and keyboarding.
5. Must complete 116 clinical clock hours before program completion.
6. Student must be able to travel up to 100 miles to satisfy clinical rotation requirements.
______________________________ ______________
Student signature
EMT-Basic Information packet
___________________________
Date
July 2013
Health Science
(Vocational Nursing, ADN, ADN Transition, Emergency Medical Services Professions, Echocardiography Technician,
Diagnostic Medical Sonography)
Student Information Data Sheet
Please print the following information:
Last Name
Middle Name
First Name
Maiden Name
Suffix (Jr. III)
Please list other names you have been known by: _________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
Date of Birth: ______\______\_______
Social Security #: _________\_______\_________
Texas Driver’s License #: ________________________
State Issued: __________________
Height: ________ Weight: __________ Gender (M or F): _______
Ethnic Group: __________
(1=White 2=African American 3=American Native/Aleutian 4=Asian/Filipino 5 = Hispanic 6=other) (Enter
appropriate number)
Natural Color of Hair: _________________ Color of Eyes: ____________
Place of Birth: ____________________________
EMT-Basic Information packet
July 2013
Hill College Student Information
Health Sciences and EMS
Hill College has partnered with Verified Credentials to manage your program requirements including the
following:

Background Report
To access Verified Credentials – Student go to:
http://scholar.verifiedcredentials.com/hillcollege
How It Works:
1. Enter code for the program you will be attending located above the “Get Started!” button on the
right side of the page
Health Sciences and EMS Program
BBKPC-26727
2.
3.
4.
5.
6.
Create an account
Enter all required information
Provide supporting documentation
Track your progress
Information will automatically be shared with your school
If you have any questions, our Client Services Team is ready to assist you. Please call us at 800.938.6090 or
email us at ClientServices@verifiedcredentials.com
EMT-Basic Information packet
July 2013
Disabilities/ADA
In accordance with the requirements of the Americans with Disabilities Act (ADA) and the regulations
published by the United States Department of Justice 28 C.F.R. 35.107(a), Hill College’s designated ADA
coordinator, Melanie Betz, Director of Academic Advising & Student Success, shall be responsible for
coordinating the College’s efforts to comply with and carry out its responsibilities under ADA. Students
with disabilities requiring physical, classroom, or testing accommodations should contact the Director of
Academic Advising & Student Success, Melanie Betz, at (254) 659-7651.
Nondiscrimination on the Basis of Disability
Federal law prohibits us from making preadmission inquiry about disabilities. Information regarding
disabilities, voluntarily given or inadvertently received, will not adversely affect any admission decision. If
you require special services because of disability, you may notify the Office of Student Development. This
voluntary self-identification allows Hill College to prepare appropriate support services to facilitate your
learning. This information will be kept in strict confidence and has no effect on your admission to the
college. Hill College has designated the Vice President of Student Development as the Section 504
Coordinator. Also Hill College complies with state regulations that allow no illegal drugs on Campus.
Students caught with such a drug may be suspended from the college for a specified period of time.
General Admission Requirements to the College
Applicants to the Emergency Medical Services Professions Program must meet the general
admission requirements to the college as outlined in the college catalog.
General College Information
Hill College is an affirmative action/equal opportunity educator institution and employer. The
College does not discriminate on the Basis of Disability. Please refer to the Hill College Catalog for
further information on any of the following policies or general college information. 1. Affirmative
Action/Equal Opportunity
2. Nondiscrimination on the Basis of Disability
3. General Admission Requirements to the College;
4. Overdue Financial Obligations
5. Financial Aid
EMT-Basic Information packet
July 2013