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Common Questions

What is the California PM 101 form?

The California PM 101 form is an application for registration as a school audiometrist. It is used by individuals who conduct hearing tests in California schools. This registration is necessary for those who meet specific training and employment criteria as outlined in the Education Code.

Who needs to fill out the PM 101 form?

Individuals who are employed as school audiometrists or qualified supervisors of health must complete this form. This includes school nurses, health department employees, and those with relevant California credentials in fields such as speech and hearing or education for the deaf and hard of hearing.

What are the requirements to submit the PM 101 form?

To successfully submit the PM 101 form, applicants must provide:

  1. A completed PM 101 application form.
  2. A transcript of records or official grade cards showing satisfactory completion of required training in audiology and audiometry.
  3. A registration fee of $10, payable to the California State Department of Health Care Services.

All these documents should be mailed together to the designated address provided in the form instructions.

Where should I send the completed PM 101 form?

Send the completed PM 101 form, along with the official transcript and registration fee, to:

California Department of Health Care Services
Accounting Section, Cashiers MS 1101
P.O. Box 997413
Sacramento, CA 95899-7413

Who can I contact if I have questions about the PM 101 form?

If you have any questions regarding the PM 101 form or the registration process, you can reach out to the Hearing Conservation Specialist at (916) 323-8087. They can provide assistance and clarify any concerns you may have.

Document Specifications

Fact Name Details
Governing Law California Education Code Sections 44879, 49420, and 49452
Purpose The PM 101 form is used to apply for registration as a School Audiometrist in California.
Application Fee A registration fee of $10 is required upon submission of the application.
Required Documents Applicants must submit a completed PM 101 form and a transcript verifying audiology training.
Submission Address Applications should be mailed to California Department of Health Care Services, Accounting Section, Cashiers MS 1101, P.O. Box 997413, Sacramento, CA 95899-7413.
Contact Information Questions can be directed to the Hearing Conservation Specialist at (916) 323-8087.
Form Version The current version of the PM 101 form is dated 09/07.
Educational Background Applicants must provide information about their college education, including major and highest degree obtained.
Current Employment Status Applicants must indicate their current employment status, including roles as school nurses or other relevant positions.
Signature Requirement Applicants must sign and date the application to validate their submission.

Dos and Don'ts

When filling out the California PM 101 form, it is important to follow specific guidelines to ensure your application is processed smoothly. Below are six things you should and shouldn't do during this process.

  • Do print or type your information clearly to avoid any misunderstandings.
  • Do include all required documents, such as your official transcript and registration fee.
  • Do double-check your personal information for accuracy before submitting the form.
  • Do ensure that you sign and date the application to validate it.
  • Don't leave any sections of the form blank; provide information for all required fields.
  • Don't forget to mail your application to the correct address, as specified in the instructions.

Misconceptions

There are several misconceptions surrounding the California PM 101 form that can lead to confusion for applicants. Understanding these misconceptions can help clarify the registration process for school audiometrists. Here are nine common misunderstandings:

  1. Anyone can conduct hearing tests without registration. Many believe that any individual can perform hearing tests in schools. However, only those registered as school audiometrists are authorized to conduct these tests.
  2. The PM 101 form is only for school nurses. While school nurses can apply, the PM 101 form is also for other qualified individuals, such as health department employees and students in relevant fields.
  3. The registration fee is optional. Some think they can skip the registration fee. In reality, a $10 fee is required to process the application.
  4. Transcripts are not necessary. It is a common belief that applicants can submit the PM 101 form without transcripts. However, official transcripts verifying completed training in audiology and audiometry are mandatory.
  5. Once submitted, the application is guaranteed approval. Some applicants assume that submitting the form means automatic acceptance. Each application is reviewed, and acceptance is not guaranteed.
  6. Only degrees in audiology are accepted. There is a misconception that only specific degrees qualify for registration. In fact, various educational backgrounds can meet the requirements, as long as they fulfill the necessary training in audiology and audiometry.
  7. The application process is quick and easy. Many underestimate the time it takes to process applications. Depending on the volume of submissions, it can take time for the department to review and respond.
  8. All applicants must have prior experience. Some believe that prior work experience is mandatory. However, students currently studying in relevant areas can also apply.
  9. The PM 101 form is the only requirement for registration. There is a notion that submitting the PM 101 form alone suffices. In reality, applicants must also provide transcripts and the registration fee for their application to be complete.

By clearing up these misconceptions, applicants can approach the registration process with a better understanding and ensure they meet all necessary requirements.

Documents used along the form

The California PM 101 form is an application for registration as a school audiometrist. Along with this form, several other documents may be required to complete the registration process. Below is a list of commonly used forms and documents that accompany the PM 101.

  • Transcript of Record: This document provides proof of the applicant's educational background, specifically verifying the completion of required training in audiology and audiometry.
  • Official Grade Cards: Similar to transcripts, these cards show the applicant's grades in relevant courses. They serve as an alternative to transcripts for verifying educational qualifications.
  • Registration Fee Payment: A payment of $10 is required for the registration process. This fee must be included with the application and can be paid via check or money order made out to the California State Department of Health Care Services.
  • Employment Verification Letter: This letter confirms the applicant's current employment status, particularly if they are employed as a school nurse or in a related health department role.
  • California Credential Documentation: If applicable, documentation proving the applicant holds a California credential in speech and hearing, education of hard of hearing, or education of the deaf must be submitted.
  • Application Instructions: A set of guidelines that outlines the steps for completing the PM 101 form and submitting the necessary documents. This is typically included with the application.
  • Contact Information: This document includes details for reaching the Hearing Conservation Specialist for any questions regarding the application process or requirements.

Gathering these documents is essential for a successful application process. Each item plays a critical role in verifying the qualifications and eligibility of the applicant to serve as a school audiometrist in California.