Health Sciences Dental Hygiene Program
Pre-Enrollment Policy Acknowledgment Form

For your application to be reveiwed by the Health Sciences Division, you must submit this form within the dates for the Enrollment Filing Period.

·       I have reviewed and sought clarification as needed of the referenced policies.    

·       I agree to abide by these policies while enrolled in the Dental Hygiene Program

·      I am aware that I must notify my instructor, the Dental Hygiene Director,  or Dean of Health Sciences immediately of any situation relevant to these policies as directed in the program policy.   

I have read and understand the following policies:        

•  Pre-Enrollment CBC & Drug Screening   
•  CBC/Criminal Convictions/Drug Screening-Enrolled Students 
•  Clinical Requirements  
•  Safe Clinical Practice  
•  Blood-Borne Pathogens Policy 
•  Technical Standards  

If you need clarification of the above policies, or need to discuss personal issues related to these policies, please contact the Health Sciences and University Programs at 530-339-3606. Staff can provide clarification and answer questions or, if appropriate, can schedule an appointment for you with the Dental Hygiene Director or Dean of Health Sciences. 
 

I understand this acknowledgment will be placed in my student file.