Respiratory Care - Application Packet

The Respiratory Care - Application Packet below includes:

Clinical Verification Form
Letter of Intent
Respiratory Therapy Clinical Site Affiliations
Schedule of Classes
Application Checklist
Application Packet
- CRT - RRT Procedures
- Procedures
- Returning Student Application
- Affiliation
- Check List for Respiratory Care Students
- Success Tips
- Recommendation Form

Respiratory Therapy - Clinical Site Visitation Form
Each prospective student should spend a minimum of 3-4 hours at the hospital during each visit. The therapist assigned to the prospective student should attempt to expose the student to as many different types of patients, hospital personnel, and areas as possible.
Student Name__________________________________________________________
Visitation Site__________________________________________________________
Visitation Date__________ Arrival Time__________ Departure Time___________
Therapist's Signature____________________________________________________
Based on your visit and discussions with the Respiratory Therapists and other staff, answer the questions below:
1. What was the most important thing you learned from your visit to this hospital?

2. Did you see anything that makes you think this field may not be for you, or that made you feel nervous or scared? (This will not immediately disqualify you from the program; please be honest in your responses.)

3. What part of your visit surprised you the most? Why?

Personal Portfolio Information

Your personal portfolio is a representation of yourself and your achievements as well as your weaknesses. It should address how you are working on your weaknesses and what you have learned about yourself.

The portfolio should contain the following:

Your 500-word typed essay should address your future career and personal goals, what becoming a respiratory care practitioner will do for you and why you should be admitted to the program.
There are books and web resources available to assist you in developing your portfolio. One such book is Portfolio Power: The New Way to Showcase All Your Job Sand Experiences.
The portfolio should be brought with you to the interview in a binder. Remember, this is a professional representation of yourself. It will be reviewed for the following criteria and each category could receive 20 points each for a total of 100:
Completeness: all of the above items must be present
Creativity
Professional presentation
Grammar and punctuation
Ability to follow directions

Tips for Successful Completion of Prerequisites:

Do not take Chemistry before Algebra
In order to be ready for Chemistry, the student should achieve a "C" or better
Psychology and English can be taken together
It is acceptable to take one science course with any general education course
It is an acceptable work load to take Anatomy/Physiology with one other science course but not in the summer unless you are an exceptional student and are not working
Do not take Anatomy/Physiology, Microbiology and Chemistry together unless you are a full-time student, not working and live at home
Any science course is hard during the summer unless it is taken by itself
It is better to take Anatomy/Physiology II and Technical Writing or its equivalent before entering the program
To transfer a course the student must have a "C" or better unless it was part of another degree
For every hour that the student is in class, three hours outside of class should be spent studying for that class
Other courses that can be helpful:
- HHS 101 Medical Terminology
- MEA 205 Electrocardiogram
- MEA 212 Phlebotomy
- HHS 105 Medical Law and Ethics
- MEA 102 First Aid and CPR
- CSI 174 Computer Literacy
- SPN 101 Spanish I
- SPN 102Spanish II

Respiratory Therapy - Letter of Intent - Part-Time Program
Please check one:
____ Indianapolis – Part-time Tract
____ Indianapolis – Full-time Tract
____ Anderson – Part-time Tract
I, ____________________________ have completed, or will have completed all of my prerequisites for the Respiratory Therapy Program on or by the end of the Spring semester of __________ (year). I intend to submit my completed Application Packet no later than February 28 th of the previously cited year.
I will schedule an appointment with the Program Chair or Director of Clinical Education before February 15 th of the previously cited year.
Thank you,	___________________________________
Signature Date	___________________________________
Printed	___________________________________
Street Address	___________________________________
City, Zip, State	___________________________________
Phone Number	___________________________________
Email Address	___________________________________
Social Security #	___________________________________

The following hospitals have an affiliation agreement with Ivy Tech Community College of Indiana. The perspective student can contact the below individuals to set a date and time for a hospital visitation.

Clinical Site	Contact	Phone Number
Ball Memorial	Kathy Stephens	765-741-1085
Bloomington Hospital	Vicki Katterhenry	812-353-9572
Columbus Regional	Jane McLeod	812-376-5312
Hancock Memorial	Charity Bowling	317-468-4504
Heart Hospital of Indiana, 106th & Meridian	Darla Harwood	317-583-5029
Hendricks County	Bob Weaver	317-745-3484
Indiana Heart Center, I-69 & 82nd St	Neil Boyce	317-621-8185
Johnson County	Brenda Wilkerson	317-736-3261
Kindred – Indianapolis, 10th St. Campus	Lydia Goar	317-636-4400
Kindred – Greenwood	Linda Stevens	317-888-8155 x 380
Major Hospital	Christy Matlock	317-421-5681
Methodist Hospital	Doug Sparks	317-929-5063
Putnam County	Sandy Park-Teelon	800-394-9338 x 2652
Regional – Terre Haute	Kalynda Denman	812-232-0021 x 2147
Riley Children's	Colleen Finley	317-274-1002
Riverview	Nancy Collett	317-776-7906
St. Francis – Beech Grove	Linda Cochran	317-783-8901
St. John's – Anderson	Anna Clevenger	765-646-8126
St. Vincent – Indianapolis	Jill Bridgewater	317-338-2204
St. Vincent – Carmel	Diane Anderson	317-582-7128
Select Rehab – Methodist	Greg Peckham	317-931-5212
Select Rehab – St. Francis	Elaine Locke	317-783-6546
Union – Terre Haute	Robin McCallister	812-238-4919
University (IU Med Center)	Chuck Christoph	317-274-1674
VA Medical Center	Jewell Hicks	317-554-0000 x 2923
Westview	Mike Weingartner	317-920-7155
Wishard	Maria Marisol-Manalang	317-630-6135
Witham - Lebanon	Lester Feller	765-482-8000

Check list for Respiratory Therapy Program:
__________	1. Complete prerequisites.
__________	2. Submit Letter of Intent to Program Chair no later than January 15. No forms will be accepted after this date. This date is for both the Full-time and Part-time tracts of the program.
_________	3. Schedule & attend a counseling session with the Program Chair or Director of Clinical Education no later than February 15. Please bring a copy of previous college transcripts (if other than Ivy Tech) with you. This does not have to be an official copy.
_________	4.Submit official transcript(s) from other colleges / universities you have attended to Registrar by February 28. These cannot be hand delivered; they must be mailed to: Ivy Tech Community College of Indiana c/o Office of the Registrar One West 26 th Street PO Box 1763 Indianapolis , IN 46206-1763
_________	5. Submit Application Packet to the Program Chair no later than February 28
Application Packet Contents: Copy of previous college transcripts (does not have to be official copy) Four (4) completed Recommendation Forms ; ensure they are signed to be considered valid Two (2) Hospital Visitation Forms ; must be from 2 separate clinical sites Personal Statement Essay – 500 words, double spaced This should explain why you want to be a Respiratory Therapist, what your life goals are, how Respiratory Therapy will help you get there, and what you see yourself doing in the future (ex: 10 years from now). Autobiography Essay – 2-3 pages, double spaced This should give a picture of who you are, what makes you unique, what “life experience” you have, and what you want us to know about you as an individual.
Send Application Packet to: Ivy Tech Community College of Indiana Respiratory Therapy Program c/o Program Chair 9301 E. 59 th St Indianapolis , IN 46216 Make an extra copy of all items submitted in Application Packet for you own records and for resubmission to the program, if requested.

Application Packet

CRT - RRT Procedures
Returning Student Application
Affiliation
Check List for Respiratory Care Students
Success Tips
Recommendation Form

Respiratory Therapy - Application steps for CRT to RRT/AAS program

Complete application for admission to college
Provide copy of all college transcripts, CRT certificate, and state certification
Take ASSET test for college admission
Retake CRT exam provided by Ivy Tech to verify current CRT knowledge levels.
Must pass at national standard.
Meet with program faculty to develop curriculum list.

Sample curriculum schedule

Semester 1 (spring)
RES 123 Cardiopulmonary Physiology 3 hrs/wk
xxx xxx General Education Requirement 3 credits
Semester 2 (summer)
RES 223 Pharmacology 3 hrs/wk
RES 229 Emergency Management 2 credits
Semester 3 (fall)
RES 222 Critical Care II 3 hrs/wk
RES 226 Clinical Medicine II 3 hrs/wk
RES 227 Clinical Practicum IV 1-3 credits
Semester 4 (spring)
RES 221 Cardiopulmonary Diagnostics 3 hrs/wk
RES 226 Continuing Care 2 hrs/wk
RES 227 Clinical Practicum IV 1-3 credits
Semester 5 (summer)
RES 227 Clinical Practicum IV 1-3 credits
xxx xxx General Education Course 1-3 credits
Semester 6 (fall)
xxx xxx General Education Course 3-6 credits
Semester 7 (spring)
*RES 227 must total six credits
General Education courses taken at time to be decided upon by participants:
- MAT 111 Intermediate Algebra 3
- CHM 101 Introductory Chemistry I 3
- ENG 111 English Composition 3
- PSY 101 Introduction to Psychology 3
- ENG 211Technical Writing 3
- BIO 101 General Microbiology I3
- ANP 101 Anatomy and Physiology I 3
- ANP 102 Anatomy and Physiology II 3

Recommendation Form

To Whom It May Concern:

____________________________________ is an applicant for acceptance into the Respiratory Therapy Program of Ivy Tech Community College of Indiana, Indianapolis. Please complete this letter of recommendation on their behalf by either circling the appropriate number or by placing an “X” in the appropriate box which you feel best correlates to their performance in the specified areas. Please be as honest as possible in your evaluation.

This letter should then be place in the student’s Application Packet to be submitted no later than February 28 th.

Each applicant is to submit four (4) Recommendation Forms: 3 business and 1 personal Recommendation Forms are required. A mean value will be calculated based on these 4 submissions. This score will then be used in the selection process of applicants for admission into the Respiratory Therapy Program.

	Very Poor			Very Good
1. Attendance	0	1	2	3
2. Punctuality	0	1	2	3
3. Interest & Enthusiasm	0	1	2	3
4. Interpersonal Communication Skills	0	1	2	3
5. Appearance	0	1	2	3
6. Works well with Others	0	1	2	3
7. Acceptance of Criticism	0	1	2	3
8. Stress Management	0	1	2	3

Printed Name of Reference

_________________________________________

Signature of Reference

_________________________________________

Date

_________________________________________

Please mark one:

Instructor_____ Friend_____ Employer_____ Other_____

Specific Location of Affiliation (if other than Friend)
__________________________________________________________________

Respiratory Therapy - Non-Traditional or Returning Student Application Procedures

Ivy Tech Technician Graduate
If you have graduated from an Ivy Tech technician program and are now a CRT, you may apply to complete your RRT and/or your Associate of Applied Science degree. All applicants must demonstrate current CRT-level knowledge by having passed the CRT exam in the last two years OR must retake current CRT exam. Please read below to see which category applies to you.A. Currently a CRT who wishes to become only RRT eligible. You must:

Have four years of experience past date of certification.
Have a total of 62 semester hours of classes required by NBRC. These classes
must be verified by the NBRC.*
Complete the classes listed by the NBRC.**

B. Currently a CRT who wishes to upgrade to RRT/AAS. You must:

Complete RRT-level classes/general education classes.** (See attached sheet) OR
Show completion of RRT exam via route requiring 62 semester hours of classes
and four years post-CRT experience. Successful completion of registry exam will
count for the registry-level classes. Complete required general education classes.

This route will require verification from NBRC.

C. Currently a RRT who graduated from an Ivy Tech technician program and wishes to gain an Associate of Applied Science degree. You must:

Complete required general education classes. (See attached sheet for classes)*

Non-Ivy Tech Technician Graduate If you are a CRT who has graduated from any CoARC approved program, you may apply to complete the registry and/or associate degree program. Please read below to see which category applies to you. A. Currently a CRT who wishes to become only registry eligible. You must:

1Have four years experience past date of certification and demonstrate 62 semester hours. The NBRC will tell you what credits you are missing.* These credits may be taken at Ivy Tech.** No degree is awarded.

B. Currently a CRT who wishes to gain an Associate of Applied Science degree and become registry eligible.You must:

Demonstrate current knowledge by having passed the CRT exam in last two years OR retake current CRT exam.
Apply for admission to Ivy Tech and take ASSET/Success seminar test.
Provide Ivy Tech with a copy of all college transcripts. Applicable classes will be transferred. Work experience will be granted for CRT level classes.
Complete class list given to you by program faculty. The list of classes will depend on college-level work already completed and results of ASSET test.

* The NBRC may be contacted at: NBRC Executive Office, 8310 Nieman Road,Lenexa, Kansas 66214; (913) 599-4200 ** All applicants to Ivy Tech may be asked to take the ASSET exam at the time of admission. Waivers for this exam may be discussed with program chair or testingdepartment staff. Additional questions concerning the program should be directed to: Respiratory Care Practitioner Program, Ivy Tech Community College of Indiana, P.O. Box 1763, Indianapolis, IN 46206-1763; (317) 921-4410; Program Chair Marcus Stowe, MS, RRT; Director of Clinical Education Jennifer Reece RN, RRT; Email: mstowe@ivytech.edu.

Respiratory Therapy Program Application Checklist

Check list for Respiratory Care Program:

Complete prerequisites.
Submit Letter of Intent to Program Chair no later than January 15. No forms will be accepted after this date.This date is for both the Full-time and Part-time tracts of the program.
Schedule & attend a counseling session with the Program Chair or Director of Clinical Education no later than February 15.Please bring a copy of previous college transcripts (if other than Ivy Tech) with you.This does not have to be an official copy.
Submit official transcript(s) from other colleges / universities you have attended to Registrar by February 28.These cannot be hand delivered; they must be mailed to:
Ivy Tech Community College of Indiana
c/o Office of the Registrar
50 W. Fall Creek Parkway, North Drive
Indianapolis, IN 46208-5752
Submit Application Packet to the Program Chair no later than February 28

Application Packet Contents:

Copy of previous college transcripts (does not have to be official copy)
Four (4) completed Recommendation Forms ; ensure they are signed to be considered valid
Two (2) Hospital Visitation forms must be from two separate clinical sites.
Personal statement essay - 2-3 pages double spaced.
Autobiographical essay - 2-3 pages double spaced

❏Send Application Packet to:
Ivy Tech State College
Respiratory Therapy Program
c/o Program Chair
9301 E.59th St
Indianapolis, IN 46216

Make an extra copy of all items submitted in Application Packet for you own records and for resubmission to the program,if requested.Students interested in entering the respiratory care program should follow the steps listed below. They should contact the program chair (317-921-4410) or the director of clinical education (317-921-4696) to make an appointment when they have three or less prerequisite courses remaining to complete, in order to discuss the steps listed below.

Respiratory Therapy - Tips for Successful Completion of Prerequisites

Do not take Chemistry before Algebra
In order to be ready for Chemistry, the student should achieve a "C" or better
Psychology and English can be taken together
Any general education course is ok with one science course
It is an acceptable work load to take Anatomy/Physiology with 1 other science course but not in the summer unless you are an exceptional student and are not working
Do not take Anatomy/Physiology, Microbiology and Chemistry together unless you are a full-time stu- dent, not working and live at home
Any science course is hard during the summer unless it is 1 course only
It is better to take Anatomy/Physiology 2 and Technical Writing or its equivalent before entering the program
To transfer a course the student must have a "C" or better unless it was part of another degree
For every hour that the student is in class, 3 hours outside of class should be spent studying for
that class
Other courses that can be helpful:

HHS 101 Medical Terminology
MEA 205 Electrocardiograms (3)
MEA 212 Phlebotomy (3)
HHS 105 Medical Law and Ethics (3)
MEA 102 First Aid and CPR (2)
CSI 174 Computer Literacy (2)
SPN 101 Spanish I (4)
SPN 102 Spanish II (4)

When you have 3 or less prerequisites left, make an appointment with the Respiratory Therapy Program Chair at (317) 921-4410 or with the Director of Clinical Education at (317) 921-4696 for further assistance.