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IMU APPLICATION FOR ADMISSION

Select The Term In Which You Would Like To Start *
Full Name *
Social Security Number *
Address *
City *
State/Province *
ZIP/Postal Code *
Country *
Primary Phone Number *
Primary Email Address *
Emergency Contact Person Name and Phone Number *
Highest Level of Education Attained *Applicants must be at least 18 years of age and have a high school diploma or GED.
School(s) Attended *
Please list all schools attended (High School, GED, or College/University) along with the address, city, state, ZIP code and graduation date (if applicable) of each school separately. For example: ABC High School - 1234 Great Future Way Atlanta, GA 30303; 05/28/2003 EFG College - 9876 Brighter Path Atlanta, GA 30317; 12/15/2007
Major *Please enter your major field(s) of study (if applicable) at all previous institutions. For example: High School - College Prep or Technical ABC College - Business Administration

EDUCATIONAL ELIGIBILITY

1. Which one of the following best describes you?
(Select 1)I have a high school diploma or GED with a GPA of 2.7 or higher.I have a completed college degree.I do not have a high school diploma, a GED, or a completed college degree.
2. Are you willing and prepared to obtain your education in a fast-paced, accelerated learning environment?
3. Are you prepared to enroll into IMU’s Diagnostic Medical Sonography Program as a full-time student committed to Monday–Friday didactic and clinical courses? * *Schedules are discussed during the interview process.

HEALTH AND IMMUNIZATION

1. Are you able to provide documentation of the following immunizations and/or titers prior to enrollment? Measles, Mumps, and Rubella (MMR), Varicella (Chickenpox), Tetanus, Diphtheria, and Pertussis (TDAP), Tuberculosis (TB) Screening, Influenza (Flu Vaccine), and Hepatitis B.
If No, please indicate which immunizations you are unable to provide documentation for in the space below.
2. Although IMU does not require the COVID-19 vaccination, some clinical affiliates may require it for placement. Are you willing to provide proof of obtaining the COVID-19 vaccination or can provided a letter of declination?
3. Are you willing to learn and maintain a high standard of professionalism, courtesy, and cooperation when interacting with peers, instructors, clinical mentors, and patients?
4. Are you willing to complete and submit an IMU-provided physical examination form completed by a licensed physician or nurse practitioner prior to enrollment?

CLINICAL REQUIREMENTS

1. Are you capable of rotating through clinical sites for a minimum of one year as part of the program?
2. Are you capable of obtaining clinical hours at sites located throughout the Metro Atlanta area?
3. Do you have dependable transportation to travel to and from assigned clinical sites and the school?

HEALTH AND SAFETY EXPECTATIONS

1. During clinical training you may experience occupational exposure to blood or other potentially infectious materials. Are you willing to participate in the clinical training?
2. Are you able to meet the essential technical and physical requirements necessary to perform the duties of a Diagnostic Medical Sonographer? See ADA technical standards and Sonographer technical/physical standards
3. Are you willing to learn and follow ultrasound standards, protocols, and procedures required in clinical environments?
4. Are you able to maintain patient confidentiality in accordance with HIPAA regulations? –See HIPAA information below.
5. Are you willing to learn and respond appropriately to emergency situations in a healthcare setting?

ADDITIONAL INFORMATON

1. Are you a U.S. citizen?
2. Are you a U.S. Veteran?
3. Can you provide proof of U.S. citizenship?

UNOFFICIAL TRANSCRIPT

Please upload your unofficial transcript here | Accepted file formats PDF, JPG, DOC, DOCX, PNG *

LEGAL ACKNOWLEDGMENT OF APPLICANT

Before submitting this form, please read and acknowledge the following statements: *
I affirm that the information provided is accurate and truthful to the best of my knowledge. Also, I understand that any misinformation or missing documentation may lead to either a delayed or a denied enrollment.I understand that a $50 non-refundable application fee must be submitted with this application before it can be processed.
*ADA Technical Standards for the Profession of Diagnostic Medical Ultrasound In accordance with the Americans with Disabilities Act (ADA), the Institute of Medical Ultrasound considers all applicants for admission without discrimination. Reasonable accommodations may be provided to qualified individuals with documented disabilities when such accommodations do not fundamentally alter the program or compromise patient safety. Diagnostic Medical Sonographers are healthcare professionals who play a critical role in assisting physicians with the diagnosis of medical conditions by performing and evaluating diagnostic ultrasound examinations and assisting with certain interventional procedures. As part of this role, sonographers must demonstrate the cognitive, psychomotor, and professional behaviors necessary to safely perform required clinical duties. Students enrolled in the Diagnostic Medical Sonography program must be able to perform the essential technical functions of the profession in a manner that ensures the safety and well-being of patients, coworkers, and themselves. The following technical standards describe the physical, mental, and behavioral abilities generally required for participation in the program and clinical training. These examples are not all-inclusive, and essential functions may be evaluated on a case-by-case basis.
A. Physical Requirements Students must possess sufficient strength, coordination, mobility, and manual dexterity to perform the duties required during sonographic examinations and clinical training. These include the ability to: · Remain standing or walking for extended periods of time (often up to 80% of a work shift). · Use both hands, wrists, arms, and shoulders to maintain prolonged scanning positions and perform precise fine motor movements required for ultrasound imaging. · Lift, move, or assist with the movement of equipment or patients, which may require lifting or supporting 50 pounds or more, with or without assistance. · Assist in transferring patients from wheelchairs, stretchers, or beds and help position patients safely for examinations. · Push, pull, bend, reach, and stoop while positioning patients and maneuvering ultrasound equipment. · Use sensory abilities including vision, hearing, and touch to: o Accurately view ultrasound images and recognize color distinctions on monitors o Hear patient responses and equipment signals o Coordinate hand–eye movements required for scanning procedures o Recognize changes in a patient’s physical condition · Work effectively in low-lighting environments typical of ultrasound examination rooms. · Maintain the physical stamina required to safely perform assigned clinical duties.
B. Cognitive and Intellectual Requirements Students must demonstrate the critical thinking, communication, and organizational skills necessary to perform diagnostic ultrasound procedures safely and effectively. These include the ability to: · Communicate clearly and professionally, both verbally and non-verbally, with patients, instructors, physicians, and other healthcare professionals. · Explain procedures, obtain relevant patient information, and provide clear instructions to patients during examinations. · Follow instructions and clinical protocols accurately while working as part of a healthcare team. · Organize and perform sonographic procedures in the proper sequence according to established medical and program standards. · Observe, evaluate, and interpret ultrasound images to ensure proper technique, protocol adherence, and image quality. · Recognize abnormal findings or technical concerns and respond appropriately. · Think critically and apply problem-solving skills to optimize imaging quality and support accurate diagnostic outcomes. · Respond appropriately and efficiently to verbal instructions, patient needs, and clinical situations.
C. Emotional and Professional Requirements Students must demonstrate the emotional stability, professionalism, and interpersonal skills necessary to function in demanding healthcare environments. Students must be able to: · Provide compassionate care and emotional support to patients during sonographic procedures. · Interact respectfully and effectively with patients, families, faculty, and healthcare professionals. · Work with individuals who may be ill, injured, anxious, or in distress. · Maintain composure and perform effectively in stressful or time-sensitive clinical situations. · Adapt to changing clinical environments and patient care priorities. · Demonstrate professional behavior, integrity, and ethical conduct consistent with healthcare standards. · Show respect and cultural sensitivity toward individuals from diverse backgrounds, beliefs, and communities. · Uphold the professional values of compassion, service, accountability, and respect for patient dignity.
*Health Insurance Portability and Accountability Act (HIPAA Health Insurance Portability and Accountability Act (HIPAA) The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy and security of patients’ medical information. It requires healthcare providers, staff, and students to keep Protected Health Information (PHI) confidential. PHI includes any information that can identify a patient, such as names, birth dates, medical records, ultrasound images, diagnoses, or insurance information. Students in the Diagnostic Medical Sonography program at the Institute of Medical Ultrasound must follow HIPAA guidelines at all times during clinical training. This includes accessing patient information only when necessary for educational or patient care purposes, not discussing patient information in public areas, and never sharing patient information, images, or videos without authorization. Failure to follow HIPAA regulations may result in disciplinary action, removal from clinical training, dismissal from the program, and possible legal penalties.

Applicant Statement of Accuracy

Applicant Statement of Accuracy *I certify that the information provided in this application is true, accurate, and complete. I understand that providing false or misleading information may result in denial of admission or dismissal from the program.
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