Health Support Specialist

Outreach Health Support Specialist Forms

This form is a checklist of paperwork that must be completed before, during and after an HSS course has been taught by the instructor. This form must be read thoroughly, signed and returned to the college before classes are taught.

To be filled out by the instructor or facility coordinator when books are distributed to students.

To be filled out by the instructor or facility coordinator ten work days before class is scheduled to begin.

To be filled by instructor everyday of each class. This form is mandatory for the Department of Labor.

To be filled out by the instructor when class has been completed.

To be filled out by the student when they begin the Health Support Specialist program. Students only need to fill out one admission form for the entire program.

To be filled out by the student along with the admission form. This form is for statistical purposes only.

To be filled out by instructors for travel expenses and meals when teaching an HSS course.

“This product was funded by a grant awarded under the President’s Community-Based Job Training Grants Initiative, as implemented by the U.S. Department of Labor’s Employment & Training Administration.  The information contained in this product was created by a grantee organization and does not necessarily reflect the official position of the U.S. Department of Labor. All references to non-governmental companies or organizations, their services, products, or resources are offered for informational purposes and should not be construed as an endorsement by the Department of Labor. This product is copyrighted by the institution that created it and is intended for individual organizational, non-commercial use only.”