School of Allied Health and Life Sciences Certificate in Public Health
CERTIFICATE COMPLETION CHECKLIST FORM
Date: ______________________ Student Name: _____________________________________________________ Which certificate program(s) is student pursuing? (Circle all that apply.) Graduate Certificates: Emergency Management [EM] Environmental Health [EH] Infection Control [IM] Occupational Safety and Health [OSH] Undergraduate Certificate: Readiness and Response [PHPR] Occupational Safety and Health [OSH] ______________________________________________ Semester/Year of Acceptance Application accepted for: ________________________________________ Semester/Year of Completion _____ Graduate Certificate
CODE EM1 EM2 EM3 SEMESTER/YEAR GRADE
____ Undergraduate Certificate
EMERGENCY MANAGEMENT BSC 5856 Bioterrorism PHC 5xxx Public Health Preparedness HSC 6528 Strategies for the Prevention of Infectious Disease
INFECTION CONTROL BSC 5856 Bioterrorism HSC 6528 Strategies for the Prevention of Infectious Disease PHC 6251 Disease Surveillance and Monitoring MCB 5271 Epidemiology of Infectious Disease
CODE IC1 IC2 IC3 IC4
SEMESTER/YEAR
GRADE
ENVIRONMENTAL HEALTH PHC 6251 Disease Surveillance and Monitoring PHC 6005 Disease Transmission in the Urban Environment PHC 6310 Environmental Toxicology PHC 5xxx Occupational Safety in the Health Care Environment
CODE EH1 EH2 EH3 EH4
SEMESTER/YEAR
GRADE
OCCUPATIONAL SAFETY AND HEALTH PHC 4xxx/5355 Fundamentals of Occupational Safety and Health PHC 4xxx/5xxx Fundamentals of Industrial Hygiene PHC 4xxx/5xxx Occupational Safety in the Health Care Environment
CODE OSH1 OSH2 OSH3
SEMESTER/YEAR
GRADE
READINESS AND RESPONSE BSC 4854 Bioterrorism PHC 4138 Medical Disaster Management PHC 4xxx Public Health
CODE PHPR1 PHPR1 PHPR3
SEMESTER/YEAR
GRADE
Courses completed for: ____ Undergraduate Certificate _____ Graduate Certificate To receive a Certificate at the graduate level, all courses must be completed at the graduate level. CERTIFICATE COMPLETION: APPROVED _____ COMMENTS: DENIED _____
_______________________________________________________________________________________________ APPROVAL SIGNATURE: ACADEMIC ADVISOR DATE