Prerequisite Forms

All prerequisites must be completed and sent two weeks prior to start of class.

Bristol Community College Center for Workforce & Community Education
Nurse Assistant Training
Davol 777 Elsbree St. Fall River, Ma 02720

Or

Bristol Community College
Nurse Assistant Training – Taunton Center
2 Galleria Mall Drive Taunton, MA 02780

Drop off forms to 2nd floor Room 229 at 1082 Davol St., Fall River or Fax: 508.730.3273 Attn: Nurse Assistant Training Program.

Certificate of Physical Examination and Immunization (Physical Form)

• Must have received a physical exam within the last year.
• Must provide documentation of Immunizations; including Tetanus, Varicella, MMR, Hepatitis B or declination form for Hepatitis B.
  
  

Criminal Offender Record Information (CORI) Request

• Must submit a C.O.R.I Application. A positive C.O.R.I may prevent students from completing the clinical requirement of the program.
  
  

Sex Offender Record Information (SORI) Report

• Must submit the S.O.R.I. application. A positive SORI may prevent students from completing the requirements of the program.
  
  

Completed Tuberculosis Skin Test Form

• Must be done within the past year.
  
  

Consent for Drug/Alcohol Testing and Hep B Declination Test

• Must be signed and dated.
• You are required to fill out the second form if you request not to receive the Hepatitis B Immunization Series.
  
  

Nursing Assistant Training Program Standards Form

• Describes standards of the program, must be signed and dated.
  
  

Completed Contact Information Form

• Must be completed prior to first day of class.
  
  

Nurse Aide Training Reading and Math Placement Test

• Must submit a copy of High School Diploma or GED prior to or on first day of class.
• Must be able to pass the Nurse Assistant Training Reading and Math Placement test or provide documentation of a High School Diploma or GED.
• Contact program coordinator at 508.678.2811, ext. 2663 to set up a time to take the placement test.