Applications ChecklistHealth Form and Liability Coverage Requirements
Download Health Form and Course Applications

 Applications Checklist

To successfully process your application, Emory WOCNEC needs the following:

• Your completed Application for Admission (download below) and the mandatory non-refundable application fee of $100.00, made payable to Emory WOCNEC.
  
  
• Official transcript(s) (cannot be faxed, must be mailed in a sealed envelope, preferably from a college or university).
  
  
• Documentation of your current nursing license.

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 Health Form and Liability Coverage Requirements

While a completed health form and proof of nurse's liability coverage must be on file and current before students can participate in any clinical exercise on the Emory campus (including the foot and nail clinic that is included during the onsite component for all students), these documents do not have to be included with the initial application. However, the health form and proof of coverage must be submitted one month prior to class for ten-week traditional onsite and six-week split option students, and one month prior to the onsite week for distance learning students. Please see the specific requirements for these items below:

• Current proof of nurses liability coverage is mandatory (one million each claim and three million aggregate). Please send a copy of the face sheet of your policy. NOTE: If covered by your employer’s insurance policy, send a copy of the face sheet for the agency AND a letter from the agency stating that you WILL BE COVERED during your clinicals while in Georgia.
  
  
• The completed Health Form (download below) must include:
  
  Current negative PPD or current negative chest x-ray. Please note that PPD is valid for six months for six-week split-option and onsite distance learning students, and for three months for ten-week traditional students. Therefore, we ask that you not acquire your PPD until approximately two weeks to ten days before your first day of class on campus.
  
  A simple, written statement from an MD stating that you are physically fit to take this course.
  
  Documentation of current vaccination against rubella, rubeola, and mumps (must be within the past ten years) OR serologic evidence of immune status OR date of birth before January 1, 1957.
  
  Positive history of chicken pox (and date); if you have NOT had or don't know if you've had chicken pox, you MUST attach serologic evidence of your status.
  
  Documentation of Hepatitis B Immune status OR documentation that you have declined the vaccine and accept full responsibility for potential exposure to Hepatitis B.
  
  Current documentation of Universal Precautions training (a copy of a sign-in sheet or a brief statement from employer, etc.).

Please contact 404.778.4067 with you any questions or concerns regarding the application process.

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 Download Health Form and Course Applications

Adobe Acrobat Reader is necessary to open and download PDF files.

• Application for Ten-Week Traditional Onsite Program
  
  
• Application for Six-Week Split Option with Offsite Preceptorship Program
  
  
• Application for Distance Learning with Offsite Preceptorship and One-Week Onsite Instruction
  
  
• Brochure and Registration Form, Wound Management Course for Treatment Nurses
  
  
• Health Form
  
  
• WOCN Scholarship Application

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