Application Letter for Accreditation - DOC by oks97298


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                   7777 Leesburg Pike, Suite 314 N. · Falls Church, Virginia 22043
                   Tel. 703/917.9503 · Fax 703/917.4109 · E-Mail:

                            (Programmatic Applicants Only)

Name of Institution:

ABHES ID Code (Renewal Applicants Only):

Mailing Address:

City:                                              State:                           Zip Code:

Telephone:                                                            Facsimile:

Name and title of chief executive officer:

E-Mail Address:

Name and title of on-site director/ head administrator:

E-mail Address:

Name and title of program head:

E-mail Address:
*Note: Important ABHES correspondence and updates to be provided via e-mail. Contact the Bureau immediately
should there be changes to the e-mail address(es) provided.

Web site Address:

Based upon our review of the basic requirements outlined in the Accreditation Manual under Chapter II,
Section B (Medical Assisting, Medical Laboratory Technology, Surgical Technology), for programmatic
accreditation, we believe that our program(s) meets the criteria; and, therefore, submit an application for
an initial or renewed grant of programmatic accreditation by the Accrediting Bureau of Health Education
Schools (ABHES).

In support of this application, we offer the following information:

1.      This application is for (check one):

             New accreditation        Continue Accreditation

        Specify (check all that applies):      Medical Assistant         Medical Laboratory Technology
                                               Surgical Technology
Application for Accreditation
Page 2 of 5

2.     The program(s) is/are offered at (check one):
              A public or private institution at the postsecondary level accredited by an agency
              recognized by the U.S. Department of Education or Council on Higher Education
              Accreditation (CHEA) whose principal activity is education;
              A hospital or laboratory based training school;
              A Veteran Administration (V.A.) hospital, rehabilitation facility, or a federally-sponsored
              Armed Forces program.

3.     Is/are the program(s) vocational in nature and designed to lead to employment?
            Yes             No

       If no, explain:

4.     Does the institution use a separate *classroom facility?
       (*Note: If the classroom facility is within reasonable walking distance, it is considered part of
       the campus and NOT considered a separate classroom).

            Yes               No

       If yes, provide the following information for each separate classroom facility:

       Separate classroom facility attached to which main or non-main location:


       City, State, Zip:

       Phone number:

       Distance from the main or non-main to which it is assigned:

       A.         Staff is limited primarily to instruction.                                 Yes           No
       B.         Administration is from the main or non-main campus.                        Yes           No
       C.         Are students at this facility required to attend classes at the main or non-main campus?
                      Yes               No
       D.         All permanent records are maintained at the main or non-main campus.
                      Yes               No
       E.         Is within customary and reasonable commuting distance of the main or non-main campus.
                      Yes               No

       If you answered “no” to any of the questions A-E above, explain:

       *Continue providing requested information above for any additional separate classroom

5.     Our institution has been legally operating and continuously providing instruction as an institution
       since (Month & Year):

                                                                                                    May 2009
  Application for Accreditation
  Page 3 of 5

  6.     Identify the institution’s oversight agency(ies) and approval expiration(s), if applicable. (Note: The
         institution must evidence that it is licensed, chartered, or approved to provide education beyond the
         secondary level under the laws and regulations of the state or territories in which it is located).

  7.     ***Has state approval of the institution/program ever been removed?             Yes               No

         If yes, explain:

  8.     Our institution and/or program(s) is/are accredited by the following professional organizations
         (include programmatic accreditation):

  9.     ***Has accreditation ever been initially denied or removed (e.g., denial, withdrawal, suspension,
         revocation, relinquishment) from your institution and/or program(s) by this or any other accrediting

             Yes             No

         If yes, explain:
         ***NOTE: An applicant must describe any current, previous, or final action of which it is the
         subject, including probationary status, by a recognized institutional accrediting agency or state
         agency potentially leading to the withdrawal, suspension, revocation, or termination of accreditation
         or licensure. Action on the application will be stayed until the action by the other accrediting
         agency or state agency is final. A copy of the action letter from the agency must be included with
         the application. Further, the institution must provide evidence of compliance with ABHES
         requirements and standards relative to the action.

  10.    Complete the program chart below for all programs for which you are seeking programmatic

Program Title                  Weeks in      Clock       Credits (specify)    %                Credential
                               Length        Hours          Quarter           Distance         Awarded upon
                                                            Semester          Education        program
                                                                                               (Specify: Certificate,
                                                                                               Diploma, AOS, AAS,
                                                                                               or AS degree)

                                                                                                      May 2009
      Application for Accreditation
      Page 4 of 5

      11.       For the program(s) listed above in Question #10, complete the chart below to identify the first
                students enrollments and first graduates:

Program Title                  Initial             # Enrolled     Initial        # Graduated   Credential [the
                               Enrollment                         Graduation                   institution] Awarded
                               Date                               Date                         upon program
                               (month/year)                       (month/year)                 completion

      If there have been no graduates in the program(s) listed above, identify month and year at which time
      students will have completed at least 25% of the program(s)?

      12.       Has a representative from each program for which you are seeking programmatic accreditation
                attended an ABHES Accreditation Workshop within in past 12 months?     Yes            No

                If yes, identify name and title of the individual(s):

                Workshop Date & Location Attended:

      The information and data submitted here are certified to be correct and current to the best of my

      Name and Title of Chief Executive Officer:

      Signature:                                                                 Date:

                                                                                                      May 2009
Application for Accreditation
Page 5 of 5

If applying for a new/initial grant of accreditation, a current school catalog, completed Ownership
Disclosure Form, and signed Attestation of Responsibility must accompany the completed Application for

ABHES prefers that ALL APPLICANTS submit completed application packets electronically via e-
mail to This may require documents to be professionally scanned as a JPG, TIF,
Microsoft-Compatible, or ADOBE PDF to ensure that all information is legible and organized for ease of
an electronic review. If the documents are scanned in per page and consist of more than two pages,
please combine them into one document. All documents must include the required signatures where

Application packets may also be submitted on CD Rom (mailed to the address below). When saving
required documents, a separate document should be made and appropriately labeled and formatted as
described above.

The total number of attachments (if e-mailed) or files (if using a CD Rom) is dependent on the
application plus the number of exhibits to accompany the application. Each attachment/file should be
named according to its content (e.g., “Completed Application”, “signed Ownership Disclosure
Form”, “Catalog”, etc.).

It is imperative that the application submission is properly labeled with the (1) institution’s name, (2)
city/state, (3) ABHES ID #, if application, (4) Entitled “APPLICATION FOR ACCREDITATION”, and
(5) the Date of submission.

The only hardcopy document required is a cover letter of intent and the application payment in the
form of a check made payable to ABHES and mailed to the address below. Visit the ABHES
website to view the current Fee Schedule at A separate fee applies to each program for
which you are seeking programmatic accreditation (Medical Assistant, Medical Laboratory Technology,
and/or Surgical Technology).

                                7777 Leesburg Pike, Suite 314N
                                 Falls Church, Virginia 22043
If you have any questions regarding the application, please call us at 703-917-9503.

                                                                                               May 2009

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