Student Forms

Related Information

OTA Student Forms

  • THESE FORMS MUST BE DATED WITHIN A SPECIFIC DATE RANGE TO BE VALID. PLEASE REFER TO YOUR ORIENTATION PACKET FOR THE DATE RANGE.
  •  Background check/drug screen, TB, malpractice insurance and physical examination must be repeated each year of the OTA Program. CPR is valid for 2 years. These requirements must be current during the entire OTA Program. 

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Student Checklist - First Year OTA Students
OTA Class of 2022 Student Checklist Form
Student Checklist - Second Year OTA Students
OTA Class of 2021 Student Checklist Form
Background Check/Drug Screen
  • Choose SCREENING: SD Consortium Criminal Background Check And Drug Screen ($77.00) .....Due to holiday drug screen can be over 3 days as long as it is done before June 4 deadline so you can turn it in with packet.  TURN IN THE E-MAIL THAT SAYS:  SUBJECT:  PAYMENT CONFIRMATION

 

  • The day of your urine drug test, DO NOT drink more than 8 oz. of any liquid . If you drink an excessive amount of liquid prior to conducting your urine drug screen, the results will be diluted and/or altered and therefore incomplete. If your drug screen results come back dilute, you will not be able to be placed in clinical settings therefore, you will be ineligible to enter the OTA Program.  SECOND  YEAR BACKGROUND/DRUG SCREEN MUST BE DATED DURING THE MONTH OF NOVEMBER DURING YEAR TWO OF THE PROGRAM.
Malpractice Insurance

Please do this online go to www.hpso.com - 1. Click on Individuals 2. click on students  3. click on Get Professional Liability Insurance Quote 4. click on individual  5. select California 6. Certified Occupational Therapy Assistant 7. select no 8. select student 9. continue  10. type in June 3 of two years from when you started 11.  Complete online application......

CPR Card

Only 1 card is accepted. American Heart Association Basic Life Support for Healthcare Providers  (2 year card)     NOTE:  only go through the 1 website listed. https://cpr.heart.org/en/cpr-courses-and-kits/healthcare-professional/basic-life-support-bls-training

TB Test

Tuberculin FORM  

Immunizations

Immunization Forms and Instructions or Immunization Waiver Form

 

Physical Examination

Physical Exam Form - If the doctor indicates your hearing is within normal range, you do not need to have a hearing test.

Flu Vaccine

Flu Vaccine Form or Flu Vaccine Decline Form ** see OTA Handbook regarding waiver

 

Influenza update

The Occupational Therapy Program will no longer accept FLU MIST (nasal spray) per new Federal Advisory Committee on Immunization Practices (ACIP) and the Center for Disease Control (CDC).  Students must have the influenza vaccination which is offered through Grossmont College Health Services or a physician's office.

OTA Essential Functions

 

Essential Functions/Skills Form

Consent Form

Consent Form

Health Insurance

HEALTH INSURANCE RESOURCES  & ENROLLMENT SPECIALIST ON CAMPUS

 

OTA Student Clinical Site Forms

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Clinical Accident/Illness/Injury Information and Claim Form
 INSTRUCTIONS AND FORMS
HIPAA Training and Standard Precautions

NEW HIPAA MODULE LINK - OTA SECOND YEAR STUDENTS MUST READ THE MODULE ON THE LINK INDICATED THEN COMPLETE THE POST TEST, PRINT, AND TURN IN WITH YOUR SECOND YEAR PAPERWORK PACKET. HIPAA TEST

 

www.cdc.gov/HAI/ppt/ppe/PPEslides6-29- 04.ppt - OTA students must read the powerpoint, print the test below, complete test, fill in date and name, and submit to the OTA Office with your second year paperwork. STANDARD PRECAUTIONS POST-TEST

OTA  Exit Form / OTA Re-Entry Form -  Found in the most recent version of the OTA Student Handbook