Application Packet

Application Packet Instructions

Students complete and submit a Phlebotomy Clinical Application packet during the semester they are in ALHT 102/102L: Introduction to Phlebotomy.

The following documents should be completed, placed in a sealed single large envelope, and addressed to:

Bossier Parish Community College
Division of Science, Nursing, and Allied Health
Attn: Pam Tully
6220 E. Texas Street
Bossier City, LA 71111

  • Allied Health Program ApplicationPDF File
  • Essential RequirementsPDF File
  • Physical Exam formPDF File(completed by a doctor)
  • Hospital Observation formPDF File(completed during ALHT 102)
  • Copy of driver’s license
  • Copy of current American Heart Association Basic Life Support (BLS) for Healthcare Provide Certification
  • Copy of OSHA Certification (or letter from instructor verifying completion)
  • Copy of HIPAA Certification (or letter from instructor verifying completion)
  • Documentation of all immunization and blood test results
    • Hepatitis B vaccination series (a minimum of the first of three injections)
    • Hepatitis B titer* (if all three injections, above, have already been received)
    • Varicella titer*
    • Rubella titer*
    • Negative TB skin test or negative chest x-ray report (current for year)
    • 2 MMR (only 1 MMR if born before 1957)
  • Health insurance verification

*Note: Contents must be downloaded, completed, and then submitted with packet

Deadline for Clinical Application Packet Submission

Students are encouraged to submit all parts of the packet in a large envelope and turn it in as soon as possible. Students will not be considered for clinicals until all parts of the packet are turned in and completion of the packet has been verified. It is the student’s responsibility to ensure that the packet is completed and received. The deadline date is the second Thursday in April and November each year. No alterations to the packet are accepted after this date.

Allied Health Program Application

Neatly type all information requested on Allied Health Program ApplicationPDF File. It must be printed, SIGNED, and included in your application packet.

Essential Requirements

The Phlebotomy Program has established Essential Requirements,PDF Fileidentifying occupational-specific technical standards required of students in the program. Please print, read and Sign this document and include it in your application packet. If you have questions or concerns related to your ability to meet these described requirements, please contact your academic advisor.

ARF (Academic Rating Form) Request Form

Part of your application packet is an academic rating form completed by three of your college instructors. Complete this ARF request formPDF Fileproviding us with the name and email address of the instructor you would like us to use. The two-page Academic Rating FormPDF Filewill be emailed to the instructor and will be returned directly to the program admissions committee for scoring via email. It is recommended that you contact the instructors and inform them that you have requested BPCC to send them an ARF.