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8110 Gatehouse Road, Falls Church, VA 22042

Inova Phlebotomy School – Online Application

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Application for Admission – Inova Phlebotomy School

Inova Health System, an Equal Opportunity Employer, shall not because of race, color, religion, age, sex, national origin or handicap, fail or refuse to hire qualified applicants.

Address
Have you previously applied?
Are you authorized to work in the U.S.?

NOTE: All applicants must be legally eligible to work in the United States. Documentation must be provided for verification.


Education

Example: 2015 to 2019
School Address
Did you graduate?

Address of College
Example: 2017 to 2021
Did you graduate?

Address of Institution
Example: 2019-2021
Did you graduate?

References

Please list two individuals whom you have asked to submit a letter of recommendation for you. Prefer professional/educational references.

Submit references to InovaPhebSchool@inova.org.

Address
Address

Submit references to InovaPhebSchool@inova.org.


Previous Employment (if any)

Please enter the name of the employer. 
Address
Example: 2019 to 2021
May we contact your previous supervisor for a reference?

Please enter the name of the employer. 
Address
Example: 2019 to 2021
May we contact your previous supervisor for a reference?

Phlebotomy Information


Essential Functions for Admission to Inova Phlebotomy School

Prior to admission each student must agree that they can, and are prepared to meet these requirements with or without reasonable accommodation.

Inova Phlebotomy School is an equal opportunity employer. Inova does not discriminate on the basis of gender, age, race, color, creed, religion, pregnancy, or related medical conditions, marital status, national origin, mental or physical disability or any other characteristic protected by applicable federal, state, or local law.

The School will provide reasonable accommodations to otherwise qualified students with disabilities.

The following is a list of the technical abilities and skills required:

1. Manual Dexterity

  1. Be able manipulate objects precisely that require fine or gross motor skills using good eye-hand physical coordination.
  2. Be able to carry objects weighing up to 20 pounds and have the stamina to perform program functions over an 8 hour day including standing, walking or sitting.
  3. Be able to maneuver freely in the clinical laboratory setting and in a patient-care setting.

2. Vision

  1. Be able to distinguish colors, and clarity.
  2. Corrected vision to 20/20

3. Communication Skills

  1. Be able to communicate in English, both verbally and in writing to all, team members, students, patients, and other healthcare workers

4. Intellectual and Critical Thinking Skills

  1. Be able to solve problems and apply critical thinking under normal and stressful situations.

5. Ethical Standards

  1. Exercise ethical judgement, integrity, honesty, dependability, patient confidentiality and adhere to the academic and professional code.

6. Safety

  1. Be able to recognize and respond to safety issues, including recognizing emergency situations and taking appropriate actions.
  2. Be able to adhere to the regulations of accrediting agencies, comply with safety regulations of the laboratory and maintain a safe environment for themselves and others.

7. Internal and External Customer Service

  1. Demonstrate excellent customer service to all patients, students and Inova team members they encounter.
  2. Fully participate in lecture and internship requirements.

Please read the above listed technical standards carefully, and then complete the statement below.


A diploma, GED or transcript must be submitted to InovaPhebSchool@inova.org.


Disclaimer and Signature

I attest that I have read and understood the technical standards of the program in the Inova Phlebotomy School. Further, I believe that I am able, and am prepared to, meet these requirements.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to appointment to the Inova Phlebotomy School I understand that false or misleading information in my application or interview may result in my release.

Sign above

Applicant Data Record

Applicants are considered for all positions, and employees are treated during employment without regard to race, color, religion, sex, national origin, age, sexual orientation, marital or veteran status, medical condition or disability.

Government agencies require periodic report on sex, ethnicity, disable and veteran status of applicants. As an employer, we comply with government regulations and Affirmative Action responsibilities.

Solely to help us comply with government record keeping, reporting or other legal requirements, please fill out the Affirmative Action Survey on this page. This data is for periodic government reporting and Affirmative Action only. It will be detached from the Application to the Inova Phlebotomy School and kept in a separate, confidential file.

We appreciate your cooperation. Providing this information is voluntary. Refusal to provide this information will NOT affect your consideration for the Inova Phlebotomy School in any way.

Check One
Check One

Note: Submit completed attachments to InovaPhebSchool@inova.org.

With this application please submit the non-refundable $50 application fee online at: https://www.inova.org/phlebotomy-school-payments