Health Professions Interest Form
Hello! The questions below will help us to provide you with the most relevant information quickly. You can also always reach out to admissions@llcc.edu and someone will assist you with any questions or concerns.
Program of Interest
If you had to only pick one, which would be your top program of interest?
If you're unsure, that's ok! Just type "I need help deciding" and pick that option.
Top program of interest - OLD Saved for data purposes. KEEP HIDDEN
Basic Nurse Assistant (CNA)
Central Sterile Service Tech
Clinical Medical Assistant (CMA)
CNA to CMA Bridge
Dental Assistant
Diagnostic Medical Sonography
Electrocardiogram (ECG) Tech
Emergency Medical Services (EMS)
Fire Science Tech
LPN to ADN
Massage Therapy
Medical Coding
Neurodiagnostic Tech
Occupational Therapy aAssistant
Phlebotomy Training
Practical Nurse (LPN)
Radiography
Respiratory Care
Surgial Tech
Transition to Surgial Tech
Vascular Sonography
Vet Assistant
I am unsure
Are there other programs that interest you besides the one you picked above?
Yes
No
Which ones?
Basic Nurse Assistant (CNA)
Central Sterile Service Tech
Clinical Medical Assistant (CMA)
CNA to CMA Bridge
Dental Assistant
Diagnostic Medical Sonography
Electrocardiogram (ECG) Tech
Emergency Medical Services (EMS)
Fire Science Tech
LPN to ADN
Massage Therapy
Medical Coding
Neurodiagnostic Tech
Occupational Therapy aAssistant
Phlebotomy Training
Practical Nurse (LPN)
Radiography
Respiratory Care
Surgial Tech
Transition to Surgial Tech
Vascular Sonography
Vet Assistant
Not Sure
When are you wanting to get started taking classes?
ASAP
Within six months
Within a year
Within two years
Your Academic Background
Do you have any of these certifications or degrees?
CNA
CMA
LPN
Sonography Cert
Bachelor's Degree
Associate's Degree
Did you take high school chemistry?
Please select...
No
Yes
Yes and I got a C or better in it
We dont need an exact number, but roughly, what is your college or high school GPA?
About You
Have you applied to LLCC already?
Yes
No
First Name
Last Name
Phone Number
Email Address
Date of Birth
mm/dd/yyyy
Contact Preference
Please select...
Call
Text
Email
Which best applies to you?
Please select...
I'm currently in high school
I graduated high school already
I have my GED
I'm working on my GED
None of the above
GED Completion Year
Or anticipated completion year
What High School did you go to?
HS Graduation Year
Or anticipated graduation year
Do you want us to share any information about Health Profession programs with anyone else? Such as a parent, friend, or other relative?
Yes
No
We can share general information about the programs you're interested in so they are aware of the details in addition to you.
Person's Name
Person's Email Address
Person's Relation to You
Please select...
Friend
Parent/Guardian
Family Member
Questions?
Finally, are there any specific questions you would like to have answered or any specific information that you're looking for?
Hidden
Program ID
HS ID
Contact Information