- Attestation Form (Excel)
- Attestation Form (Diagnostics and Therapeutics, Pharmacy, Imaging, and Rehabilitation services only)
- Badge and Parking Directions
- COMPASS Training (MyLearning) Form (Faculty only)
- COMPASS Access Agreement for Faculty
- COMPASS Access Agreement for Students
- Medical Clearance Form (Return to Clinical)
- Pre-placement Requirements Modules
Austin Radiological Association
Baylor Scott & White
Cedar Park Regional Medical Center (CPRMC)
Central Texas Medical Center
Encompass Health (Round Rock)
Encompass Health (Ben White)
- Clinical Rotation Checklist
- Information Security Compliance Form
- Hospital Orientation In-Service
- Student Database Form
- Confidentiality Agreement
- HIPAA Student Training
St. David’s HealthCare Partnership
- Faculty Orientation Manual
- Student Orientation Manual
- ICARE Values Commitment Form
- Accudose Security Agreement
- Attestation Form
Health Information Privacy
Injury and Illness Claims
- Injury and Illness Prevention Program
- Incident Reporting Form – Handwritten forms are no longer accepted. You must use a PDF editor such as Adobe Reader to complete this form.
- Workers’ Compensation Insurance
Student Accident Claims
Do not send to the Hartford address displayed on the form. Contact information for student accident insurance claims is available on the Student Insurance page.
- Health Sciences Retention Coordinator
- ACC Early Alert Referral System (EARS)
- Counseling Services (Mental Health and Crisis Intervention)
Progressive Discipline Process
- Exit Interview Checklist
- Exit Interview Notes
- Exit Review
- Re-entry Form
- HITT Early Alert Deficiency Notification
- Student Complaint Procedures
- Report an Incident (submit a formal complaint related to college services, classroom instruction, or grade disputes)
- FERPA Website
- FERPA Consent for Release of Student Information (for department meeting with student and their guest)
- FERPA Consent for Release of Confidential Information (for Student Services)
- Student Reference Request, FERPA Release and Release of Liability
- Student Proxy Authorization Form
Contact: Melissa Tavassoli
- Phone: 223.5874
- E-mail: firstname.lastname@example.org
P Card Purchasing and Procedures
- P Card 2.0 Information
- Procedure for Department Chair
- Procedure for Faculty/Staff
- Procedure for Budget Authority
- Sales & Use Tax Exemption Form
- Missing Receipt Memo
Purchasing, Staples Advantage Orders
- P-Card is required
- Visit StaplesAdvantage.com and enter the following information:
- Account Number: 1828555DAL
- User ID: YOUR ACC E-MAIL ADDRESS IN ALL CAPS
- Password: staples (passwords are case sensitive and you will be required to change the first time you log in)
- Your Approver: No Approver
- Minimum Amount: $50.00
Purchasing, Health Sciences Division – BUSINESS CARD ORDERS
- For business card orders, complete the Business Card Order Form and e-mail to email@example.com as an attachment.
- Cards can only be ordered for Health Sciences Division employees. If you receive a request from a non-Health Sciences Division employee, please refer them to Vickie Johnson at 512.223.1043
Purchasing, Health Sciences Division – NAME BADGE ORDERS
- For name badge orders, contact Southwest Stamp and Awards, Inc. directly at 512-452-2577.
- When placing your order, notify the vendor you are with ACC so you will not be charged tax.
- You will need to pick up your order once it is complete. Visit 1308 W. Anderson Lane, Suite A, Austin, Texas 78757-1467
- To obtain reimbursement for out-of-pocket expenses, please use the Monthly Reimbursement Form.
Monthly Reimbursement Process
Petty cash and Mileage reimbursements must be approved by your supervisor within 60 days of purchase (45 days recommended). Travel Reimbursement must be approved by your supervisor and Pat Racek within 14 days of purchase (7 days recommended). The cashier’s office will not be able to process your reimbursement, regardless of the cost.
If you have any questions, please contact Melissa Tavassoli at 35874 or firstname.lastname@example.org.
- Monthly Reimbursement Instructions & Form (Mileage & Travel Requests)
- Employee Leave Request
- Texas Hotel Occupancy Tax Exemption Certificate
Purchasing, Health Sciences Division – BASIC SUPPLY/EQUIPMENT ORDERS
- For general supply orders, totals must be at least $150.00 per Vendor and per Campus to qualify for Datatel entry. Complete the Health Sciences Purchase Request Form and e-mail to email@example.com as an attachment.
- If you have an electronic quote, please forward it to firstname.lastname@example.org. If you only have a hard copy, please bring me a copy for processing.
Purchasing, Health Sciences Division – SOFTWARE ORDERS
- For software orders, there is no minimum as all software is required to process through Datatel per college guidelines. Complete the Software Order Form and e-mail to email@example.com as an attachment.
- You will be provided with an electronic quote, please forward the quote to firstname.lastname@example.org when submitting your request.
- Once your order is complete, you will receive a software link via e-mail. You must forward a copy of this link to email@example.com and enter “Receipt Confirmed” in the subject line or in the e-mail text to validate your software in the HS database. Failure to do so will void your software.
Contact: Dianne Olla
- Phone: 223.7647
- Email: firstname.lastname@example.org
Please see Karoline Gebert before submitting your schedule.