Evaluation Worksheet for Certificate Dental Assisting (Extended-22-month)
SID: ________________________________ Certificate of Achievement - 3177
  Effective: Spring 2007
  Health Sciences
Name: ________________________________ (707) 527-4447

REQUIREMENTS: Complete 42.5 units

American Dental Association Requirements - complete 8.0 units
CourseDescriptionUnitsCompletedIn ProgressComments
PSYCH 1A General Psychology3.0   
Complete any combination totaling at least 2.0 units from the following:
ANAT 140 Fundamentals of Anatomy and Physiology2.0   
BIO 10 Introduction to Principles of Biology4.0   
Complete any combination totaling at least 3.0 units from the following:
FDNT 10 Elementary Nutrition3.0   
FDNT 62 Nutrition & Diet Therapy3.0   
Dental Assisting Requirements - complete 34.0 units
CourseDescriptionUnitsCompletedIn ProgressComments
DA 60 Applied Dental Science3.0   
DA 61 Introduction to Chairside Dental Assisting3.0   
DA 62 Introduction to Dental Procedures3.0   
DA 63 Dental Specialties3.0   
DA 64 Advanced Dental Assisting2.0   
DA 65 Dental Science 23.0   
DA 66A Clinical Practice 13.0   
DA 66B Clinical Practice 24.0   
DA 67 Dental Office Management2.0   
DE 50 Introduction to the Dental Profession2.0   
DE 51 Occupational Health & Safety2.0   
DE 55A Introduction to Dental Radiology 12.0   
DE 55B Dental Radiology 22.0   
Dental Assisting (Extended-22-month) Requirements - complete 0.5 units
CourseDescriptionUnitsCompletedIn ProgressComments
DA 69 Chairside Skills Workshop0.5   

It is important that students who are completing an Associate Degree and desire to transfer to a four-year institution meet with a counselor to plan their lower division coursework. While many majors at SRJC are intended to align with lower division major preparation required by California public universities, specific lower-division major requirements vary among individual campuses. See a counselor, visit the Transfer Center, and check Guides For Transfer in Specific Majors, and ASSIST to review transfer preparation guides for specific schools and majors.


Completion of ANAT 51 fulfills the 2.0 unit ANAT/BIO requirement above.
Students must provide documentation of a recent health examination, immunization records, and copy of a current CPR card, including adult, child and infant.
All courses must be completed with a "C" or better.

Applicants who have completed all three courses required by the American Dental Association (Psych 1A, Anat 140 or Bio 10, FDNT 10 or 62) will be given preference for acceptance over applicants who have not completed all three courses. Applicants who have completed two of the courses will be given preference over those who have completed one of the courses. Applicants who have completed one course will be given preference over those who have completed none of the courses.

    Evaluation worksheet completed upon receipt of Transfer Credit Evaluation form. Includes credit from other institutions only received to date.

    Evaluation worksheet completed for ________________________________. Includes all SRJC and transfer credit received to date.

Units completed:    __________
Units in progress:    __________
Total:    __________
    Requirements Completed
    Pending (work in progress)
    Requirements Not Completed



Date: ________________________   By: ____________________________________________