Essential Skills of a Phlebotomist Form
  • MM slash DD slash YYYY
  • The following list identifies the skills that a Phlebotomy Student and Clinical Phlebotomist must possess, or be able to learn during training in a short period of time, in order to safely and effectively perform the skills required of the profession. Students entering into the program must self-disclose any areas of deficiency and are required to speak directly to their instructor as to how the deficiency may impact their ability to learn the material presented. Failure to self-disclose may result in removal from the program. Please review the following skills and check all boxes that you are physically, emotionally, and intellectually able to do. If you are not able to check all boxes, please discuss this with your instructor.
  • Technical Skills
  • I agree that by signing this document, all information contained within is truthful and accurate. I further understand that failure to perform any/all of these essential skills safely, and within a timely fashion, will prevent me from progressing to the Internship portion of the Phlebotomy Certificate. Inability to perform any skill required of the job of Phlebotomist in a safe manner as determined by my PHBC 110R Instructor may prevent me from continuing on to the Phlebotomy Internship (PHBC 190R) per the RVCC Work Based Learning Policy found in the student handbook.

    Additionally, students in programs that require successful completion of a clinical placement or internship should be aware that clinical sites are not necessarily required to recognize accommodations contained within an Individual Reasonable Accommodation Plan (IRAP) issued by River Valley Community College (“RVCC”) designed for use in classroom setting pursuant to the Americans with Disabilities Act. Please be aware that clinical sites may need to adapt any accommodation request you make in a manner that does not create an undue hardship for them and does not require them to alter the essential functions of the internship expectations. You are encouraged to discuss the accommodation process with both your site supervision and your RVCC faculty.

  • MM slash DD slash YYYY