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1 / Web: ENROLMENT FORM Training Program: Authorised Drug Collection Officer (ADCO) Date you would like to attend: / / STUDENT DETAILS: Please complete all required fields marked with an * Company Name (If applicable) Company site location (If applicable) First Name: * Middle Name Last Name: * ID Number: (e.g. Drivers Licence) Date of Birth: * Primary Phone: * Secondary Phone: Fax: Postal Address: * Address: * Gender Suburb: * Post Code: * State: * Country M / F Payment Options: (Please select 1 payment option) Purchase Order Number Please invoice my organisation on Purchase Order number I would like to pay by Cheque / Money Order BSB: Account: I will telephone Western Diagnostic Pathology with my Credit Card Details I will pay in person Student Declaration: I acknowledge that I have read and fully understand the information contained on the reverse of this form and the Carepoint Education + Training Code of Practice (available at or on request) and my rights and responsibilities as a student. I understand that it is my responsibility to be familiar with its contents and to ask questions on any matters I don t understand. I also consent with my name, date of birth, qualification and date of competency being provided to the state Training Accreditation Council in line with the AQTF client qualification register requirements. Student Signature: Date: Authorised by WDP (print name) Date:

2 / Web: Language and Cultural Diversity 6. In which country were you born? Australia 1101 Other - please specify 7. Do you speak a language other than English at home? (if more than one language, indicate the one that is spoken most often) No, English only 1201 English only - Go to Question 9 Yes, other - Please specify 8. How well do you speak English? Very well 1 Not well 3 Well 2 Not at all 4 9. Are you of Aboriginal or Torres Strait Islander origin? For persons of both, mark both yes boxes No Yes, Aboriginal Yes, Torres Strait Islander Disability 10. Do you consider yourself to have a disability, impairment or long-term condition? Yes Y No N No - Go to Question If YES, then please indicate the areas of disability, impairment or long-term condition: (you may indicate more than one area) Hearing/Deaf 11 Learning 14 Vision 17 Physical 12 Mental Illness 15 Medical Condition 18 Intellectual 13 Acquired Brain Impairment 16 Other 19 Schooling 12. What is your highest COMPLETED school level? (Tick ONE box only.) Year 12 or equivalent 12 Year 10 or equivalent 10 Year 8 or below 08 Year 11 or equivalent 11 Year 9 or equivalent 09 Never attended school In which YEAR did you complete that school level? Never attended school Go to Question Are you still attending secondary school? Yes No Previous Qualifications Achieved 15. Have you SUCCESSFULLY completed any of the following qualifications? Yes Y No N No - Go to Question If YES, then tick ANY applicable boxes. 008 Certificate III (or Trade Certificate) 514 Advanced Diploma or Associate Degree 410 Certificate II 521 Diploma (or Associate Diploma) 420 Certificate I 524 Certificate IV (or Adv Certificate/Technician) 511 Certificates other than the above 990 Employment 17. Of the following categories, which BEST describes your current employment status? (tick ONE box only) Full-time employee 01 Employed - unpaid worker in a family business 05 Part-time employee 02 Unemployed - seeking full-time work 06 Self employed - not employing others 03 Unemployed - seeking part-time work 07 Employer 04 Not employed - not seeking employment 08 Study Reason 18. Of the following categories, which BEST describes your main reason for undertaking this course (Tick ONE box only.) To get a job 01 It was a requirement of my job 06 To develop my existing business 02 I wanted extra skills for my job 07 To start my own business 03 To get into another course of study 08 To try for a different career 04 For personal interest or self-development 12 To get a better job or promotion 05 Other reasons 11

3 / Web: General Information Enrolments We request all learners / company representatives to fully complete an enrolment form. Once the enrolment form has been received, confirmation will issued. A place on a course will be reserved on receipt of full fee unless prior arrangements have been made. Fees are payable in full irrespective of the course outcome. Fees are to be paid in full or the provision of company Purchase Order on company stationery supplied prior to issuing any Statement of Attainment or Certificate of Qualification Refund / Cancellation or Deferment Policy Western Diagnostic Pathology will safeguard the fees you pay in advance. A full refund or an alternative date is offered to the learners in cases where Western Diagnostic Pathology cancels the program. If a course is commenced but not completed by a learner an agreement can be made with the RTO Coordinator / Management for a reduced fee to be paid, with the balance of advanced payments being refunded. No fees will apply if written cancellation / deferment request from a learner or client is received a minimum of 10 working days before the start of the course, with all advanced payments being refunded. For courses cancelled / deferred between 5-9 working days before the commencement date a fee of 0-50% of course fees will apply in consultation between the learner, the RTO Coordinator and management, with all advanced payments being refunded. Fees of 100% of the course fee will apply for courses cancelled / deferred within 5 workings days before the commencement date. Fees of 100% of the course fee will apply for courses not attended. All requests must be received in writing. Dress Casual clothing is recommended for comfort during our courses at the Western Diagnostic Pathology Training Venue. Training at your workplace your normal work wear. Flexible Learning & Assessment Our training and assessment procedures are flexible and are designed to take into account your needs. This means that the training and assessment you receive from Western Diagnostic Pathology (in agreement with Carepoint Education + Training) is done in accordance of the national quality training framework and any qualifications you achieve with us will be recognised anywhere in Australia. Access & Equity Western Diagnostic Pathology (in agreement with Carepoint Education + Training) are committed to the principles of training equity and we actively pursue learning and development opportunities that allow access for all sectors of the Community. Learning and development activities are conducted with the utmost regard for the rights of every individual regardless of race, colour, religion, gender, socio-economic status or any other factor.

4 / Web: Skills Recognition & Mutual Recognition Participants may apply for skills recognition. This is the process of gaining formal recognition of previous training or knowledge and skills gained through other means such as on-the-job experience or everyday life. These skills and knowledge are measured against the accredited course requirements. Western Diagnostic Pathology (in agreement with Carepoint Education + Training) recognises Australian Qualifications Framework qualifications and/or Statements of Attainment issued by any other Registered Training Organisation. Competency Assessment As part of your learning experience with Western Diagnostic Pathology (in agreement with Carepoint Education + Training), competency based assessments will be conducted and may consist of some or all of the following methods of collecting evidence, to ensure your understanding and ability to perform to the standard expected within the workplace, as expressed in the relevant, endorsed industry competency standard: Workbook Assignments Workplace Scenarios Practical Demonstrations Quiz Case Studies Role Play Policies Please refer to for the Code of Practice. This Code of Practice allows the student to understand their rights and responsibilities when they attend one of the Western Diagnostic Pathology (in agreement with Carepoint Education + Training) courses. Also listed in this document are issues that we need to bring to your attention prior to attending a training course. If you have any further queries please do not hesitate to contact Western Diagnostic Pathology on (08) or info@saferworkplace.com.au. Western Diagnostic Pathology offers the Authorised Drug Collection Officer training corse in agreement with CE+T, a Registered Training Organisation (RTO) and courses are delivered to the National Training Framework. This comprises of the Australian Quality Training Framework (AQTF) and Training Packages.

5 / Web: HLTPAT304B Collect Pathology Specimens Other Than Blood ELEMENT 1. Receive request for collection of pathology specimen PERFORMANCE CRITERIA 1.1 Assess request to determine equipment required and other special requirements 1.2 Identify precise nature and requirements of the test request 1.3 Collect relevant clinical and personal information by interview of client and document correctly 1.4 Ensure pre-test criteria are met 1.5 Refer pathology requests to supervisor if required 1.6 Use of pathology collection manuals correctly 1.7 Select and prepare equipment and appropriate collection containers 2. Perform procedure 2.1 Explain procedure to client and obtain consent in accordance with legal and organisation requirements 2.2 Follow infection control guidelines 2.3 Use personal protective equipment appropriately according to organisation policy 2.4 Use collection and clinical equipment appropriately to avoid contamination of sample 2.5 Follow organisation guidelines for safe handling of pathology specimens/non pathology specimens 2.6 Adopt standard and additional precautions and seek assistance as required 2.7 Follow appropriate procedures for collection of sample 2.8 Follow OHS guidelines relating to disposal of equipment 3. Label and store specimens for transportation 3.1 Label specimens in accordance with ISO 9000 or the National Australian Testing Authority 3.2 Process and store specimens correctly 3.3 Contain specimens appropriately for transport 3.4 Report specimens ready for transportation 4. Care for client 4.1 Position client correctly and make comfortable 4.2 Monitor client during and on completion of collection procedure to identify potential adverse outcomes