Faculty & Staff Resources


Affiliation Agreement

Cedar Park Regional Medical Center

Central Texas Medical Center

Healthsouth

  • Addendum to Clinical Affiliation Agreement (Word) (PDF)
  • Drug and Alcohol Policy (Word) (PDF)
  • Exhibit A – Statement of Confidentiality (Word) (PDF)
  • Exhibit B – Acknowledgement Form (Word) (PDF)
  • Exhibit C – Release Statement Certification (Word) (PDF)
  • HIPAA Student Training/Orientation (Word) (PDF)

St. David’s

Scott & White

Seton

Medical Clearance Form (Return to Clinical)

Health Information Privacy

ABC’s of Serving Students with Disabilities in Health Sciences

Supervisor’s Injury and Illness Analysis and Prevention Report

Student Accident Claims

Do not send to the Hartford address displayed on the form. For a list of ACC’s Environmental Health & Safety contacts, please click here.

Pro Med Treatment Authorization Form (this form is not listed under the ACC Online Forms Inventory)

Final Grade Review Form

Student Referral Forms

Progressive Discipline Process

  • Student Conference Report – (Word)
  • Student Probation Report – (Word)

Student Withdrawal Forms

  • Exit Checklist (Word)
  • Exit Review (Word)
  • Re-entry Contract (Word)
  • Interview Notes (Word)
  • HITT Early Alert Deficiency Notification (PDF)

Campus Carry Handbook (revised July 13, 2017)

VPN Setup: Supervisor needs to send a message to acctech@austincc.edu giving permission for the employee to have access. For on-campus access, please follow these instructions.

Contact: Melissa Tavassoli

P Card Purchasing and Procedures

Funds Transfer Slip

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 Science Division – BUSINESS CARD ORDERS

  • For business card orders, complete the Business Card order form and e-mail to mtavasso@austincc.edu as an attachment.
  • Cards can only be ordered for Health Science Division employees. If you receive a request from a non-Health Science Division employee, please refer them to Vickie Johnson at 512.223.1043

Purchasing, Health Science 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 mtavasso@austincc.edu.

Purchasing, Health Science Division – BASIC SUPPLY/EQUIPMENT ORDERS

Purchasing, Health Science 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 mtavasso@austincc.edu as an attachment.
  • You will be provided with an electronic quote, please forward the quote to mtavasso@austincc.edu 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 mtavasso@austincc.edu 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.