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Baptist medical center south school of medical laboratory 2026

The document is an Experience Documentation Form for applicants seeking certification as Medical Laboratory Scientists through the ASCP Board of Certification. It requires personal information from the applicant and verification of their laboratory experience by a supervisor or laboratory management. The form outlines necessary competencies in various areas of medical laboratory science, including blood banking, chemistry, hematology, microbiology, immunology, and urinalysis. It emphasizes the need for documentation of on-the-job training and competency in specified testing procedures.

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Click ‘Get Form’ to open it in the editor.
Begin with Part I by entering your name, ASCP Customer ID, address, email, city, state, zip code, and the last four digits of your Social Security number. Ensure all information is accurate for proper identification.
Proceed to Part II where your immediate supervisor or laboratory management must complete and sign the verification section. They will need to provide details about your experience including start and end dates, average hours worked per week, and check off areas of competency.
Instruct your supervisor to print their name and credentials clearly, sign the form, and include their contact information. This step is crucial for validation.
Finally, ensure that a letter of authenticity from your supervisor is included with the form. This letter should be on official letterhead confirming that the experience documentation is accurate.

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