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Clinical Application Confirmation

This page confirms that you have successfully applied for clinicals! 


Print this page for your records. Find your program information below.

EFDA
Next step - you will be contacted and provided with additional information required. If you have questions please contact Tiffany Kessler, takessle@hacc.edu, 717-780-2398. 

You will need to provide the following documentation:

Healthcare Provider CPR (copies of front & back of card)
A copy of your current Dental Assisting (CDA) certificate OR current PA Dental Hygiene License
Proof of required immunizations
Pennsylvania State Police Criminal History Request Form (SP-164)
Pennsylvania Child Abuse History Form
FBI check
Clinical Experience Verification Form

SUBMIT TO:
Mail: EFDA Program, HACC, One HACC Drive, SM 104D, Harrisburg, PA 17110
Fax: EFDA Program, 717-780-1170
Email: takessle@hacc.edu (Tiffany Kessler)