Dental Assisting (Certificate)

Fall 2014 Academic Advisement/Orientation Form

NOTE: This form is for the use of Dental Assisting students that have received a formal acceptance letter from Hudson Valley Community College Admissions Department for the upcoming fall semester. Dental Assisting does not have spring entry.

The following items MUST be completed in order to be scheduled for the upcoming Fall dental assisting courses at Hudson Valley Community College. If you do not complete the requirements below by the date specified in your letter, you will jeopardize your seat in the program. Please contact the Dental Hygiene/Dental Assisting Department (518) 629-7442 with any questions.

Student Information

Full Name: *

Address: *
Zip Code
Phone: * Date of Birth: *

Please choose one *
I will be attending the mandatory Advisement/Orientation
I am unable to comply; therefore, please take me off the list.

Mandatory Criteria

Mailed Official Documents to the Admissions Office:
High School Transcript (Official) Or Copy of GED with scores
College Transcript(s) (Official)

CPR (current) for the Healthcare Provider:
Copy of front and back of a current DANB-accepted CPR with a hands-on exam must be taken. CPR from other providers or courses will not be accepted. The card must be dated and signed or imprinted with the instructor's name, and have the certificates/applicant's name or signature on the card. Accepted CPR Providers: American Heart Association and American Red Cross.
Yes, will forward copy of card to Admissions Office
Scheduled CPR; will be certified by Orientation

Required College Immunizations, including HepB series:
Yes, on file at the Health Service Office
Will have records on file by Orientation

Photo (Two photos, passport size):
Yes, on file at the Dental Hygiene/Assisting Department
Will have photos on file by Orientation


Office Information
Financial Aid Office: Guenther Enrollment Services Center, Room 110 (518) 629-7150
Admissions Office: Guenther Enrollment Services, Room 223 (518) 629-7309
College Health Services: Fitzgibbons Health Technologies Center, Room 146 (518) 629-7468
Dental Hygiene/Dental Assisting Department: Fitzgibbons Health Technologies Center, Room 155 (518) 629-7442