Ascp forms 2025

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The document is a Work Experience Documentation Form for applicants seeking certification as Medical Laboratory Technicians. It requires the applicant to provide personal information and work experience details, which must be verified and signed by their immediate supervisor or laboratory management. The form outlines the necessary areas of proficiency in medical laboratory testing, including blood banking, chemistry, hematology, microbiology, immunology, and urinalysis/body fluids. Additionally, it emphasizes the need for a letter of authenticity from the supervisor on official letterhead.

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Click ‘Get Form’ to open the ascp Work Experience Documentation Form in the editor.
Begin by filling out Part I with your personal information, including your name, last four digits of your Social Security number, address, email address, and daytime telephone number.
Proceed to Part II, where your immediate supervisor or laboratory management must complete and sign the verification section. They will need to provide employment dates and hours worked per week.
Instruct your supervisor to review the areas of proficiency listed (Blood Banking, Chemistry, etc.) and mark an 'X' next to each area where you have demonstrated competency under their supervision.
Ensure that your supervisor prints their name, title, signs the form, and includes their contact information before submitting it along with a letter of authenticity on official letterhead.

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Versions	Form popularity	Fillable & printable
2020	4.8 Satisfied (127 Votes)
2019	4.3 Satisfied (92 Votes)
2017	4.3 Satisfied (210 Votes)
2016	4.8 Satisfied (55 Votes)
2007	4.3 Satisfied (172 Votes)

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Ascp forms 2025

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