DIALYSIS APPLICATION ∙ FALL 2020
Admission into the Dialysis Technician program is by application, and only completed applications will be
accepted. The schedule for FALL 2020 semester is available on the reverse side. Registration fee is $224
which includes: $180 registration, $5 technology, $15 security, $2 accident insurance, $16 malpractice
insurance, and $6 CPR eCard. CPR is required for clinical – must be AHA Health Care Provider.
Training includes class, lab, and clinical experiences. The course is designed to prepare individuals with
the theoretical, technical, and clinical skills needed to maintain equipment and provide patient care to
those being treated for chronic renal diseases. Class format includes lecture, laboratory, and clinical
activities. Successful completion prepares individuals for employment as a dialysis technician in hospitals,
renal dialysis facilities, and clinics. After one year of work experience, individuals may be eligible to sit for
national certification as a Clinical Hemodialysis Technician.
The Division of Continuing Education in partnership with DaVita Dialysis supports the responsibilities of the
Student Internship Program established by DaVita. Students are responsible for completing the online
background screening through HireRight and eScreen. Students must complete the drug screen through
eScreen within 72 hours of receiving the email. Internship (clinical experience) with DaVita cannot start
until the screenings have been successfully completed. It is important for the student to go online to
provide the requested information upon receipt of the emails from HireRight and eScreen.
Students must respond to all emails from DaVita within 72 hours. Students are not financially responsible
for the drug test or criminal background check. Failure to complete all the requirements listed by DaVita
will result in the student not being able to attend the clinical portion of the Dialysis program.
• Complete the Dialysis application on reverse side. Application can also be downloaded from the
wilsoncc.edu website; Continuing Education, Health Occupations page.
• Submit completed application to firstname.lastname@example.org or to the Continuing Education office on
• Copies required of the following:
• High school diploma or equivalent
• North Carolina picture ID (example: driver’s license)
• Proof of the following immunizations:
• One TB skin test within the past twelve (12) months of class start date
• Two MMR (Mumps, Measles, Rubella) injections
• Three Hepatitis B (at least the first injection prior to the start date is required)
• Varicella injection or Titer (blood test to prove immunity to chicken pox)
• Tdap (within the past 10 years)
• Flu vaccine – starting September 2020
It is the student’s responsibility to obtain copies of the required immunization records.
Keep the original record and SUBMIT COPIES ONLY.
• Dialysis - Core Curriculum for Dialysis Technicians (6
edition) – (Approximately $50)
• American Heart Association Textbook for CPR - (Approximately $20)
REQUIRED PRIOR TO CLINICAL ROTATIONS:
UNIFORMS: Teal top and white pants, white lab coat, and white, closed-toe shoes. Skirts and/or dresses
must be approved by the Instructor prior to clinical rotation.