Coordinated Program Entry Form - Physical Therapy Assistant (PTA)

Pre-Registration Screening

Before Submitting This Form

Please read the screening criteria and guidelines (https://editwww.

cnm.edu/programs/coordinated-program-entry/screening-criteria-andguidelines) for the Coordinated Entry Programs.

You cannot "save" your work and return to it later.

Submission of your form does not guarantee you a seat in the program. Screening forms will not be considered for students who have not been admitted to CNM.

When you click "submit" a screen will appear that will notify you that your form was submitted successfully. You will also receive an email confirmation to your CNM email account.

Students will be notified within 14 business days of submitting their form.

Need Help?

If you have any questions about this form, please call (505) 224-4111 or email: cpe@cnm.edu before submitting.

Program*

Physical Therapist Assistant

CNM Student ID*

Last Name*

First Name*

Primary Phone*

Please include area code when entering phone number (XXX) XXX-XXXX

Phone

Student CNM Email*

NOTE: This is the ONLY way we will contact you regarding your screening form. Make sure the address is working properly and check your account frequently. If you are experiencing any difficulties, contact Information Technology Services (ITS) at (505) 224-4357.

Entrance Examination Completion Requirement TEAS V (for Allied Health)

TEAS for Allied Health Entrance Exam

Minimum Required Scores

Comprehensive: 60%
Reading: 70.3%
Math: 67.9%
English: 58.5%
Science: 47.4%

Minimum required scores in Reading, Math, English and Science can be obtained through multiple attempts, however each attempt must have a minimum comprehensive (composite) score of 60%. If a student reaches a minimum required score in one of the four categories but does not score a 60.00% overall, the attempt will not be valid.

TEAS Reading Section Test Date*

TEAS Math Section Test Date*

TEAS English Section Test Date*

TEAS Science Section Test Date*

Information and Acknowledgements

For each of the following statements click the box to acknowledge you understand that you have met/will meet the following requirements. If you have any questions on any of these statements, please contact (505) 224-4111 or email: cpe@cnm.edu before submitting this form.

I understand that I must meet the minimum requirements for this program:*

Minimum Cumulative GPA of 3.0, Required Prerequisite Courses (finished or in progress), TEAS for Allied Health (formerly named the HOBET) exam scores.

I understand that there are limited seats for this program. I am responsible for registering for courses at the assigned date and time given to me if I am approved for registration.*

Enrollment in this program not guaranteed.

I understand that failure to submit transcripts may delay my screening for the Physical Therapist Assistant program. I also understand that it is my responsibility to resolve any holds that may appear on my student account.*

I understand the information listed regarding re-entry into Term 1 of the Physical Therapist Assistant program. It is my responsibility to review my unofficial transcripts through myCNM for previous attempts.*

I understand and verify that I meet the technical requirements to participate in the clinical education portion of this program and understand that if reasonable accommodations are needed I am to contact the Disability Resource Center.*

I understand that if I register for this program, I must complete pre-clinical requirements by a deadline.*

I understand that admittance into this clinical program is dependent upon acceptable results from a New Mexico Department of Health Background Screening, Urine Drug Screening and proof of specific immunizations.*

I have reviewed and understand the Accreditation Statement of the developing CNM Physical Therapist Assistant program.*

I understand that I must become familiar with the School of Health, Wellness, and Public Safety Handbook.*

Signature*

My signature confirms that I have read and agreed to all of the terms and conditions required to qualify to register for this program.

Send me a copy of my responses

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