Spring 2016 Online Orientation

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* 1. If you have not completed all components of the on-line orientation, please do so before beginning this survey. I acknowledge receipt of and completion of the following on-line orientation components (check all that apply):

Welcome

New Student To-Do List

Technology

Finances

Policies

Diversity Education Presentation

Getting Involved

Student Success

Registrar's Office

Library

HIPAA

ETS (I have taken the test)

Campus Safety & Security

References

Completion & Confirmation of Participation

It is mandatory to review and accept the terms listed below to be enrolled at Cabarrus College of Health Sciences. Please read each one carefully and indicate your agreement by clicking the radio button to the left of the statement.

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* 2. Release from Responsibility

I do hereby release Cabarrus College of Health Sciences, its affiliated clinical or fieldwork agencies, Carolinas HealthCare System (CHS) NorthEast and its employees, representatives, subsidiaries and affiliates from responsibility for any consequence which might occur as a result of my participation in educational programs and related College activities while I am enrolled as a student in the College.

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* 3. Confidentiality of Information/HIPAA

I hereby acknowledge understanding of CHS’ and Cabarrus College’s policies regarding protecting the confidentiality of any patient and/or student and/or employee information gained through employment or enrollment with CHS or Cabarrus College. I acknowledge receipt of information on the Health Insurance Portability and Accountability Act (HIPAA) of 1996. I understand confidential information, including non-public information regarding CHS’ or Cabarrus College’s business operations, may not be discussed outside of CHS or Cabarrus College and internally only with employees or students with a “need to know.” I further understand that this obligation shall continue even after my employment or enrollment ends. I acknowledge that if I breach my duty of loyalty to CHS or Cabarrus College, then CHS or Cabarrus College may pursue all available remedies.

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* 4. Access to and Disclosure of Student Records

I hereby acknowledge understanding of the Family Educational Rights and Privacy Act of 1974 (FERPA), which affords students certain rights concerning their educational records. FERPA considers all students independent which limits the education record information that may be released to directory information. Directory information includes: name, address (excludes e-mail), phone number, program of study, participation in officially recognized activities, most recent educational institution attended, date of attendance, degrees and awards received (including dates), enrollment status (full/part-time), class level and date of birth. Students may elect to suppress their Directory Information by going to the Office of Student Records and Information Management. The student will be required to complete and sign the “Suppression of Directory Information Request Form” officially requesting the suppression of their respective Directory Information. The College assumes that the student does not object to the release of the Directory Information unless the student files the official Suppression of Directory Information Request Form.

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* 5. Student Acknowledgement (Student Handbook and College Catalog)

I acknowledge that I have been provided information on how to access the Student Handbook and College Catalog online. I understand that printed copies of the Cabarrus College of Health Sciences Student Handbook & Academic Planner will be available at the beginning of the Fall semester. If I have any questions concerning any information contained in the Handbook, I understand I may contact Campus & Community Outreach, at (704) 403-1614 for further clarification. The "Handbook" does not constitute an enrollment contract, nor is it intended to make commitments to students concerning their enrollment with Cabarrus College. Enrollment with Cabarrus College is “at will.” As such, Cabarrus College and its students are in an enrollment relationship which can be ended by either party, at any time, and for any reason permitted by law or college policy that either deems appropriate. Again, neither the Handbook nor any other Cabarrus College policy or procedure, written or otherwise, should be construed as a contract for enrollment.

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* 6. I acknowledge that I have been informed of the following polices, resources and information, including, but not limited to:

Academic Integrity

Access to and Disclosure of Student Records and Family Educational Rights & Privacy Act (FERPA)

Annual Disclosure of Crime Statistics

Campus Safety and Security Reporting (in compliance with the Higher Education Opportunity Act (Public Law 110-315) (HEOA).

Drug and Alcohol Use and Prevention (in accordance with the Drug-Free Workplace Act of 1988 Public Law 101-690) and the Drug Free Schools and Communities Act (Public Law 101-226)

Campus and Workplace Zero Violence Policy

Net Price Calculator

Peer-to-Peer File Sharing and Copyrighted Materials

Sexual Misconduct (Discrimination, Harassment, Assault, and Retaliation)/Title IX

Title IX Coordinator information (Cara S. Lursen, Coordinator, Campus & Community Outreach, 704-403-1614, cara.lursen@cabarruscollege.edu)

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* 7. Americans with Disabilities Act (ADA)

I understand that in accordance with the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973, the Office of Advising and Student Success assists students with physical, psychological and learning disabilities in fulfilling the fundamental requirements of the curriculum by accessing reasonable accommodations to ensure that they have equal access to educational opportunities at the College. Students with a physical or mental impairment (a disability for which you believe will require accommodations, assistance with coursework or testing) that substantially limits one or more major life activities as defined under the ADA/504, should contact the Coordinator, Advising and Student Success at 704-403-1616.

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* 8. Consent for Recorded Interview, Videotape, and/or Photograph

I understand that Cabarrus College of Health Sciences makes extensive use of recorded interviews, videotapes, and photographs in its educational programs, advertising, press releases, and other promotional materials. I further understand that the above listed materials will be viewed by the general public. I have been advised that I have the right to refuse to participate in recorded interviews, videotaping, and photographs. I understand I may cancel my permission in writing at any time before the photography, filming, or other recording begins. I have read and understand this document. I hereby consent to participate in and authorize the use of my recorded interview, videotape, and/or photograph by Cabarrus College of Health Sciences for its educational programs, advertising, press releases, and other promotional materials. My signature verifies permission to photograph, film or record under the above stated terms. I acknowledge that I am 18 years of age or older.

I am a minor and need to provide consent from my parent/guardian (please see Student Affairs).

I do not authorize use. Please see Student Affairs to complete the necessary documents.

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* 9. Enrollment Agreement

Upon enrollment at Cabarrus College of Health Sciences, I become a member of the student body with associated rights and responsibilities. In order to participate responsibly as a student in all activities of Cabarrus College, it is essential that I read, understand and abide by the rules, policies and procedures established by Cabarrus College and any clinical and/or fieldwork agency policies which are applicable. I therefore do certify that I have access to the online versions of Cabarrus College of Health Sciences’ Student Handbook (http://www.cabarruscollege.edu/content/students/StudentHandbook.pdf) and Catalog (http://www.cabarruscollege.edu/content/catalog/Catalog.pdf), and that I have read and understand the specified rules, policies, and procedures set forth in these publications found at www.cabarruscollege.edu. In the future, I agree to read my Cabarrus College email and other correspondence pertaining to changes and revisions of rules, policies and procedures as these are made, and agree to abide by these changes. I have been given the opportunity to clarify any questions I have, and agree to abide by the rules, policies, and procedures as they have been set forth in electronic form and explained to me. I further certify that I understand that violation of these rules, policies and procedures may result in my probation, suspension, or dismissal from Cabarrus College of Health Sciences.

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* 10. Sharing of Health Information with CMC-NorthEast Employee Health and Clinical Sites

I authorize Cabarrus College to share information related to health and immunization records, skin tests and drug screening results with Teammate Health to ensure that enrollment requirements have been satisfied. I also authorize Teammate Health to share health, immunization, drug screen and skin test information with Cabarrus College. My signature below hereby authorizes, without reservation, Cabarrus College of Health Sciences to release my immunization record and my drug screen results and any related information to agencies providing clinical experiences for my educational program as necessary in the normal course of business. In addition, I hereby waive any and all claims or causes of action that I may have against the College or any clinical affiliation sites, resulting from the release of such information. This authorization will expire at the completion of my educational program unless previously revoked.

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* 11. Consumer Reports (Background Check)

In connection with my admission to Cabarrus College of Health Sciences, I understand that consumer or investigative consumer reports which may contain public record information, may be requested or made on me including criminal records, driving record, education, prior employer verification, workers compensation claims and others. I further understand that Cabarrus College will be requesting information from various Federal, State and Local agencies regarding my past activities. I also understand that the information regarding sex, race and date of birth is requested for the sole purpose of gathering the above information correctly, and will not be used to discriminate against me in violation of any law. I authorize Cabarrus College to share criminal background check information with clinical sites where I have been assigned during my enrollment at the College.

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* 12. Acknowledgement of Cabarrus College Email Account as Official Means of Communication

I understand that the Cabarrus College email account is the official means of communication used by the College for all enrollment related correspondence including financial aid, registration, and required documents and that it is my responsibility to monitor my account on a regular basis.

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* 13. Acknowledgment of ETS Questionnaire completion

I attest that I have completed the ETS Questionnaire, in it's entirety (undergraduate students only)

I am not required to complete the ETS Questionnaire as I am a Graduate student.

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* 14. Please tell us how you learned about Cabarrus College of Health Sciences

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* 15. Please tell us WHY you chose to attend Cabarrus College of Health Sciences

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* 16. Participation and completion

I attest that I have completed, in full, the online orientation program for new students and understand that I will be held responsible for the information contained therein.

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* 17. Verification of Identity

Name:

Email Address:

Last 4 digits of Social Security Number

You must select "done" to officially submit this document.