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Acknowledgement of Handbook Review and Receipt

This page is to acknowledge that you have reviewed and received a copy of the RRT to BSRT Student Handbook.

You acknowledge that:

  • You have read the policies and practices contained in the Handbook which includes the College of Nursing and Health Professions Social Media Policy and agree to comply with them.
  • You understand the program has the right to revise policies and practices and you agree to abide by said revisions in these policies and practices.
  • You further acknowledge that you understand that any violation of the Respiratory Therapy Program policies which include all policies set forth by the University of Southern Indiana can result in disciplinary action including possible program dismissal.

Click the button below to download this PDF. Please sign, scan and email to You can also fax this document to the attention of Jody Delp, Respiratory Therapy at 812-464-1778.