Evaluation Worksheet for Certificate Community Health Worker
SID: ________________________________ Certificate of Achievement - 3303
  Effective: Summer 2007
  Health Sciences
Name: ________________________________ (707) 527-4836

REQUIREMENTS: Complete 22.0 units

Community Health Worker Requirements - complete 22.0 units
CourseDescriptionUnitsCompletedIn ProgressComments
CHW 150 Introduction to Community Health Work1.0   
CHW 151 Outreach Techniques & 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   
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: ____________________________________________