Evaluation Worksheet for Certificate Community Health Worker
SID: ________________________________ Certificate of Achievement - 3303
  Effective: Fall 2017
  Health Sciences
Name: ________________________________ (707) 527-4836

REQUIREMENTS: Complete 27.5 units

Community Health Worker Requirements - complete 27.5 units
CourseDescriptionUnitsCompletedIn ProgressComments
CHW 150 Introduction to Community Health Work1.0   
CHW 151 Outreach Techniques and Strategies3.0   
CHW 151L Outreach Experience3.0   
CHW 152 Health Issues and Resources3.0   
CHW 152L Team Outreach Experience3.0   
CHW 153 Community Health Education3.0   
CHW 154 Disease Prevention and Health Promo Vulnerable Populations3.0   
CHW 155 Mental Health Promotion2.5   
HLE 5 Personal Health and Wellness3.0   
Complete any combination totaling at least 3.0 units from the following:
ANAT 58 Introduction to Human Anatomy3.0   
ANAT 40 Introduction to Human Anatomy and Physiology4.0   
ANAT 140 Fundamentals of Anatomy and Physiology2.0   
CHLD 10 Child Growth and Development3.0   
COMM 7 Intercultural Communication3.0   
HLC 140 Health Care Implications of Anatomy and Physiology1.0   
HLC 160 Medical Terminology3.0   
PSYCH 1A General Psychology3.0   
PSYCH 5 Abnormal Psychology3.0   

    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: ____________________________________________